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 ...
Source: The Health Care Blog - October 21, 2021 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Medical Practice Physicians Primary Care Hans Duvefelt Medical Ethics medication pharmaceuticals Pharmacy Source Type: blogs
Olanzapine FTW for Nausea Outside of CINV
by Drew Rosielle (@drosielle)A few months agoan interesting olanzapine study was published which I have been meaning to write a post about. It ' s important because while olanzapine has really established itself in the last decade as a highly effective antiemetic for chemotherapy induced nausea and vomiting, and is now in multiple CINV guidelines (eg Antiemetics: ASCO Guideline), etc, we don ' t have a lot of data for its efficacy for nausea outside of CINV, and so a well-done RCT is welcome.The study is amulti-center, US, adult, randomized, placebo-controlled, double-blind trial of olanzapine for nausea in advanced cancer...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 1, 2021 Category: Palliative Care Tags: anorexia cachexia nausea olanzapine rosielle Source Type: blogs
Top 25 Psychiatric Medications for 2018
Psychiatric medications are an important part of treatment for many people with mental disorders, such as depression, bipolar disorder, ADHD, schizophrenia, anxiety, and others. They play an important role in helping to alleviate the most serious symptoms, allowing people to better focus on their lives and on other treatment types, such as psychotherapy. Psychiatric medications are an important part of many people’s treatment plans for obtaining the most effective treatment for a mental health concern or mental illness.
It’s good to know what drugs are being prescribed most often for mental disorders in the U.S...
Source: World of Psychology - December 15, 2019 Category: Psychiatry & Psychology Authors: John M. Grohol, Psy.D. Tags: General Medications Psychiatry psychiatric meds psychiatric prescriptions Source Type: blogs
Johnson and Johnson's Latest Ethical Misadventures: Settled Kickback Allegations, Reportedly Concealed Knowledge of Adverse Effects of a " Sacred Cow " Product
Giant pharmaceutical/ biotechnology/ device company Johnson& Johnson has its famous" credo " which starts withWe believe our first responsibility is to the doctors, nurses and patients, to mothers and fathers and all others who use our products and services. In meeting their needs everything we do must be of high quality..Nonetheless, the company has a long history of ethical misadventures (lookhere, and see appendix below). Now late in 2018, we note two more Johnson& Johnson misadventures. In chronological order,$360 Million Settlement of Allegations of Kickbacks to Medicare/ Medicaid Patients to...
Source: Health Care Renewal - December 15, 2018 Category: Health Management Tags: adulterated drugs adverse effects deception impunity Johnson and Johnson kickbacks legal settlements Source Type: blogs
Antipsychotics Don't Help ICU delirium
by Drew Rosielle (@drosielle)It just gets worse and worse for the idea that antipsychotics have efficacy for delirium.Last year Iposted about the RCT of haloperidol, risperidone, or placebo for delirium symptoms in ' palliative ' patients. I ' m pretty sure I called for more controlled, ' high quality, ' trials, and we are lucky enough to have another.This one is arandomized, double-blinded, registered, controlled trial of haloperidol, ziprasidone, or placebo for ICU delirium, just published in NEJM.The trial took place in a geographically diverse group of US-based intensive care units. They enrolled adult patients in medi...
Source: Pallimed: A Hospice and Palliative Medicine Blog - October 25, 2018 Category: Palliative Care Tags: delirium icu journal article rosielle Source Type: blogs
The Curse of Delusional Parasitosis
Delusional parasitosis is a rare condition, but it is more common where methamphetamine and cocaine abuse is high. It is a fascinating condition to witness; patients are convinced that their skin is infested with foreign organisms or materials despite incontrovertible evidence to the contrary.This condition is known by numerous names—Ekbom syndrome, delusory parasitosis, psychogenic parasitosis, delusional parasitosis, delusional ectoparasitosis, formication, chronic tactile hallucinosis, dermatophobia, parasitophobia, and cocaine bugs—but delusional parasitosis and more recently delusional infestation are considere...
Source: M2E Too! Mellick's Multimedia EduBlog - September 29, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The 1000th Thread!
Discussion Blog)
Source: Bioethics Discussion Blog - December 24, 2017 Category: Medical Ethics Source Type: blogs
The 1000th Thread!
This is the 1000th presentation to my bioethics blog since starting on Google Blogspot.com in 2004.There has been many topics covered. Though comments by the visitors has always been encouraged and, since as a "discussion blog", comments leading to discussions I have felt was the definitive function here. Virtually none of the thread topics have gone unread and most have had some commentary, some with mainly particularly strong and emphatic opinions http://bioethicsdiscussion.blogspot.com/2013/01/should-pathologists-be-physicians.html, some with extensive up to 12 years long continued discussion http://bioethicsdiscussion....
Source: blog.bioethics.net - December 24, 2017 Category: Medical Ethics Authors: Maurice Bernstein, M.D. Tags: Health Care syndicated Source Type: blogs
How the MMR Vaccine Caused My Son ’ s Encephalopathy, A.K.A. Autism
In 2016 I found myself waiting at a Colorado doctor’s office with my 12-year-old son, hoping to qualify for a cannabis prescription for him. I had traveled a long way from mainstream medicine in ten years. As a West Point graduate, Army Medical Service Corps Junior Officer of the Year and Medical Intelligence Officer for NATO Peacekeeping Forces, none of those experiences adequately prepared me for the greatest medical challenge and controversy of our time. My toddler son had suffered a vaccine induced brain injury from the MMR vaccine in 2005.
The Harvard trained physician I was meeting with had been practicing medicine...
Source: vactruth.com - November 18, 2017 Category: Allergy & Immunology Authors: Pam Long Tags: Human Pam Long Top Stories Arthur Krigsman autism encephalopathy inflammatory bowel disease P.A.N.D.A.S. Source Type: blogs
Top 25 Psychiatric Medications for 2016
Most people understand that the role of psychiatric medications is to help alleviate the symptoms associated with different types of mental disorders, such as depression, bipolar disorder, ADHD, schizophrenia, anxiety, and more. Psychiatric medications are an important part of a comprehensive treatment plan for effectively treating people who have a mental health concern or mental illness.
It’s good to know what drugs are being most-often prescribed for mental disorders in the U.S. These are the top 25 psychiatric medications by number of U.S. prescriptions dispensed in 2016, according to QuintilesIMS, a global infor...
Source: World of Psychology - October 12, 2017 Category: Psychiatry & Psychology Authors: John M. Grohol, Psy.D. Tags: General Medications Psychiatry Treatment medications for mental illness Psychiatric Drugs Psychiatric Medications psychiatric meds top psychiatric medications Source Type: blogs
Lorazepam, Haloperidol, and Delirium
JAMA Internal Medicinehas published a double-blind,randomized, placebo-controlled trial of adding lorazepam to haloperidol in patients with advanced cancer and agitated delirium. (We had a heads up about this trial because it waspresented at ASCO earlier this year.) If there ever was a sort of consensus in HPM about how we should be treating delirium, my sense is that it ’s been shattered by the recentRCT of low-dose haloperidol vs risperidone for delirium in Australian palliative care unit patients, showing those drugsworsened delirium symptoms. So, it seems like we should all see what we can learn from this newly publi...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 25, 2017 Category: Palliative Care Tags: antipsychotics delirium research issues rosielle Source Type: blogs
Medications that Increase the Risks of Falling
Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don ’t.ByAlzheimer's Reading RoomWhat ’s the Difference Between Alzheimer’s and DementiaHow to Test Your Memory for Alzheimer's and DementiaHow to Get Answers To Your Questions About Alzheimer's and Dementia“Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t – perhap...
Source: Alzheimer's Reading Room, The - February 1, 2017 Category: Neurology Tags: alzheimer's care care of dementia patients dementia care health help alzheimer's help with dementia care medications falls Prescription Medications Risks risk of falling senior care Source Type: blogs
Changing Treatment Options in Delirium - No More Antipsychotics?
by Drew RosielleIntroductory CommentsThis is a post to share my thoughts about therandomized, controlled trial of haloperidol, risperidone, or placebo for delirium in ' palliative care ' patients, published recently in JAMA Internal Medicine.Big hat tip to my fellows - Drs Amanda Hinrichs, Elena Wahmhoff, and Alison Feldman, whose discussion of the paper at a recent fellows ' rounds helped me think through the study, as well as theAAHPM Connect communities bulletin board ' s discussions (BTW, have really appreciated these bulletin boards the last couple years and am grateful to AAHPM for pulling it off so well!).Geripal, a...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 28, 2017 Category: Palliative Care Tags: antipsychotics delirium journal article MDAS NuDESC rosielle Source Type: blogs
Despite Long Record of Misadventures, Johnson and Johnson to Receive Award for " Ethical Leadership?! "
What does it take for a big pharmaceutical/ device/ biotechnology company to get an ethics award?Reported by Sheila Kaplan at Stat (but for subscribers only), and first noticed by Carl Elliott and justdiscussed on his Fear and Loathing in Bioethics blog, it appears that the giant Johnson and Johnson pharma/ device/ biotech company will get an award in " ethical leadership " from and " organization called Fellowships at Auschwitz for the Study of Professional Ethics, or FASPE. "The Stat report, quoted by Dr Elliott, stated:FASPE Chairman David Goldman, an attorney in New York, said he wasaware of the pharma giant ’s vario...
Source: Health Care Renewal - December 14, 2016 Category: Health Management Tags: crime health care ethics Johnson and Johnson legal settlements Source Type: blogs
Dementia Care, Which Drugs Increase the Risk of Falling
Medications can increase the risk of falls and falling; and, are a major cause of injuries and death in older adults.By Bob DeMarcoAlzheimer's Reading RoomDuring the entire 8 and a half years, 3,112 days, that I was taking care of my mother, I worried about her falling.Falls can result in hip injuries, head injuries, or something worse.If you loved one is falling, or complaining of "dizziness" check out the list of medications below; and then, consult with your personal care doctor.Problems with Balance, Walking, Falling an Early Sign of DementiaThe drugs older people take can make them more susceptible to falling.Research...
Source: Alzheimer's Reading Room, The - September 7, 2016 Category: Neurology Tags: alzheimer's care Alzheimer's Dementia dementia care dementia falls dementia help for caregivers family caregiving help alzheimer's help with dementia care memory care searches related to falling Source Type: blogs
