We Use Too Many Medications: Be Very Afraid of Interactions

By HANS DUVEFELT I happened to read about the pharmacodynamics of parenteral versus oral furosemide when I came across a unique interaction between this commonest of diuretics and risperidone: Elderly dementia patients on risperidone have twice their expected mortality if also given furosemide. I knew that all atypical antipsychotics can double mortality in elderly dementia patients, but was unaware of the additional risperidone-furosemide risk. Epocrates only has a nonspecific warning to monitor blood pressure when prescribing both drugs. This is only today’s example of an interaction I didn’t have at my fingertips. I very often check Epocrates on my iPhone for interactions before prescribing, because – quite frankly – my EMR always gives me an entire screen of fine print idiotic kindergarten warnings nobody ever has time to read in a real clinical situation. (In my case provided by the otherwise decent makers of UpToDate.) I keep coming back in my thoughts and blogging about drug interactions. And every time I run into one that surprised me or caused harm, I think of the inherent, exponential risks of polypharmacy and the virtues of oligopharmacy. One conclusion I have come to is that too often the benefit of our prescribed medication is actually too small to justify the drug. The way drugs are approved today is pretty much that they have to bring a 20% or so advantage over placebo for a ce...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Physicians Primary Care Hans Duvefelt Medical Ethics medication pharmaceuticals Pharmacy Source Type: blogs

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Phys. Chem. Chem. Phys., 2021, Accepted Manuscript DOI: 10.1039/D1CP03678E, PaperManish Kumar, Anjali Anjali, Divya Dhingra, Ankit Yadav, Siddharth Pandey A comparison of physical properties and fluorescence quenching behavior between glycerol with a deep eutectic solvent (DES) and an ionic liquid (IL) in the presence of lithium salt as media... The content of this RSS Feed (c) The Royal Society of Chemistry
Source: RSC - Phys. Chem. Chem. Phys. latest articles - Category: Chemistry Authors: Source Type: research
We present a case of the rare Kikuchi–Fujimoto disease (KFD) in a 14-year-old patient admitted to UCLA Medical Center with fever, weight loss, and pancytopenia. Physical examination revealed tender subcutaneous nodules and cervical lymphadenopathy. A lymph node biopsy showed findings consistent with KFD. The skin biopsy showed mild superficial dermal edema with neutrophil-predominant inflammation. In addition, rare atypical monocytoid cells were seen. This histologic finding of a Sweet-like morphology has not been reported previously in the literature in association with KFD. The differential diagnosis included Sweet...
Source: The American Journal of Dermatopathology - Category: Pathology Tags: Extraordinary Case Report Source Type: research
This study confirms a subset of histopathologic features that are present in cases of BCC that are associated with neuroendocrine expression that can potentially be interpreted differently and can create a diagnostic pitfall. Neuroendocrine expression in BCCs is yet uncertain, and further studies are required to fully understand this phenomenon. To avoid diagnostic pitfalls, dermatopathologists must be aware of these unusual histopathologic features and aberrant immunostaining in such tumors; hence, it is advised to perform a thorough histologic inspection.
Source: The American Journal of Dermatopathology - Category: Pathology Tags: Original Study Source Type: research
AbstractPurposeTo assess the psychometric properties of the Turkish version of the Scale for Positive Aspects of Caregiving Experience (SPACE).Design and MethodsThe methodological descriptive study was conducted with 228 family caregivers of people with dementia (PwD) in Turkey, Izmir, between March 2018 and December 2019.FindingsThe Turkish version of SPACE is a valid and reliable measurement tool to evaluate the positive experiences of caregivers of PwD in the Turkish society.Practice ImplicationsIt is thought that this measurement tool will be useful for researchers working with primary caregivers in Turkey.
Source: Perspectives in Psychiatric Care - Category: Psychiatry Authors: Tags: ORIGINAL ARTICLE Source Type: research
HIGH cholesterol is caused by having little caution with the foods and drinks you eat, raising levels and increasing a person's risk of having a heart attack or stroke. One product taken daily could help to significantly lower your levels.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Condition:   Colorectal Tumors Interventions:   Dietary Supplement: Cohort 1: HFCS (fructose) fed;   Dietary Supplement: Cohort 2: D-Xylose (xylose-fed) Sponsor:   Weill Medical College of Cornell University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
This is the annual G. Burroughs Mider Lecture. Speaker Andrew Singleton works on the genetic basis of neurological disorders including Parkinson's disease, Alzheimer ’ s disease, dystonia, ataxia, dementia with Lewy bodies, and amyotrophic lateral sclerosis (ALS). His team seeks to identify genetic variability that causes or contributes to disease and to use this knowledge to understand the underlying molecular processes. Most recently his work has expanded to the use of multimodal data in predicting disease. Dr. Singleton ’ s group discovered a number of genetic mutations that cause disease, including the alph...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
This holiday season, we are all in search of the perfect gift. What is the one thing you truly desire for yourself and your family? Don’t you think we all want it? What if you were handed a beautifully wrapped box containing a miraculous tool that caused dramatic weight loss and good health without limiting calories or requiring exercise? What if this gift reduced appetite, shrunk belly fat, and dropped your dress size? What if that same gift freed you from acid reflux, heartburn, bowel urgency, and diarrhea, but also improved mood, increased energy, deepened sleep, and reduced or eliminated joint pain? And all of th...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Open Source Type: blogs
INTRODUCTION: Previous studies have investigated the potential role of traumatic brain injury (TBI) in subsequent development of dementia and Alzheimer's disease (AD) but reported inconsistent results. We aim to determine the association between TBI and su...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
Overdose deaths involving synthetic opioids excluding methadone (primarily illicitly manufactured fentanyl) have increased approximately tenfold since 2013 (1) and have accelerated during the COVID-19 pandemic, with provisional estimates indicating that sy...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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