By Brian D. Clark
Faculty Peer Reviewed
The ability to critically assess the validity of a clinical trial is one of many important skills that a physician strives to develop. This skill helps guide clinical decision-making, and there are a number of things that we are trained to look for to help determine the validity of any given study. Right at the top of the list of factors that go into this appraisal is that of study design, with the randomized, placebo-controlled trial serving…
By Santosh Vardhana, MD/PhD
Faculty Peer Reviewed
Ms. T is a 32- year-old woman with no past medical history who presents with a three month history of productive cough, shortness of breath, and a twenty pound weight loss. On review of systems, she also reports night sweats. On physical exam, she is cachectic. Pulmonary exam reveals dry bibasilar inspiratory crackles. Rapid HIV test is positive, and CD4 count returns at 46. Chest X-ray reveals bilateral increased interstitial markings at the lung bases as well as…
By Ishmeal Bradley, MD
Faculty Peer Reviewed
The goal of public health is to prevent or minimize disease and injury on a population level. How to achieve this end has changed over time, though. In previous decades, communicable diseases posed the greatest health risks. Consequently, public health officials used the tools of isolation, quarantine, and (forced) vaccination to combat these threats. Today, however, the major causes of morbidity and mortality are chronic conditions, many of which are thought to be due to lifestyle behaviors. Consider obesity,…
By Antonella Surbone MD PhD and Jerome Lowenstein MD
The recent hearings at the Food and Drug Administration regarding the revocation of approval for the use of Avastin in the treatment of breast cancer bring into sharp focus several very important issues in medicine today.
The pharmaceutical industry, armed with powerful new tools for deciphering the signaling mechanisms and mutations responsible for the development and progression of malignancies, has developed new therapies for treating cancer and other malignancies. The cost of development of each new…
By Lee Rasamny
Faculty Peer Reviewed
For thousands of years, humans have been fascinated with the idea of slowing and perhaps even reversing the process of aging. From Ponce de León to modern research into substances like telomerase and resveratrol, philosophers, explorers, and scientists have dedicated countless hours to this pursuit.
Resveratrol, a substance found in the skin of red grapes and other plants such as eucalyptus, spruce, and lily, has developed a buzz for its hypothesized potential to slow the…
By Jon-Emile S Kenny
Faculty Peer Reviewed
A 65-year-old female with locally advanced rectal cancer is admitted to the ICU, hypotensive and febrile. Her PICC line is removed and blood cultures drawn. Fourty-eight hours later all cultures return ESBL Klebsiella with susceptibility only to polymyxin.
I sat on the venerable call-room couch staring mindlessly at the cluttered, nauseating walls repeating the word ‘polymyxin’ like an endless antimicrobial mantra. What strange dosing it has, and an even more…
By Antony Q. Pham, Pharm.D. and Reena M. Tejura, Pharm.D.
Faculty Peer Reviewed
Recent publications have described a potential drug interaction between clopidogrel (Plavix®) and proton pump inhibitors (PPIs). Several retrospective studies have concluded that the use of PPIs can lower the effectiveness of clopidogrel and as a result, increase the possibility of cardiovascular events. Limited data from prospective trials have yet to show a clinical significance from this potential interaction. The Food and Drug Administration (FDA) released an…
John Cruz
Faculty peer reviewed
A number of studies have shown that zolpidem (Ambien), the most commonly prescribed sleep-inducing medication on the market, can produce uncontrollable nocturnal eating behavior among users. Sleep related eating disorder (SRED) is characterized by partial arousals from sleep to ingest food, usually within the first three hours after sleep onset, occurring one to six times per night.1 Patients describe an “automatic” inclination to eat and an inability to return to sleep…
Kanika Ballani, Pharm.D.
Diana Hubulasvili, Pharm.D.
Developed by Amylin Pharmaceuticals, Exenatide (Byetta®) is an incretin mimetic that is used as an adjunctive therapy with metformin, a sulfonylurea or a thiazolidinedione to improve glycemic control in type 2 diabetic patients. Mechanistically, Exenatide mimics the actions of endogenous incretin hormone, glucagon-like peptide (GLP-1), causing an increase in insulin secretion which slows gastric emptying and leads to a decrease in food intake. On November 3rd 2009, the FDA issued a safety warning on Exenatide associating…
Commentary by Marilena S. Antonopoulos Pharm.D, Pharmacology Section Editor
Until recently, drugs safety alerts (aka “Dear Doctor letters”) were sent out to physicians through traditional U.S. mail, a slow and error-prone process. These alerts can be significantly delayed and may not even reach the intended recipient. In an effort to improve the speed and efficacy of the delivery of FDA mandated patient safety alerts to physicians and other healthcare providers, the Health Care Notification Network (HCNN) has announced the launching of its online…
Commentary by Marilena S. Antonopoulos, PharmD, Pharmacology Editor
On July 8th, the FDA notified the manufacturers of fluoroquinolone antimicrobial drugs that a Boxed Warning in the product labeling and a Medication Guide for patients concerning the increased risk of tendinitis and tendon rupture is necessary. The FDA conducted a new analysis of the available literature and post-marketing adverse event reports which reconfirms that the use of fluoroquinolones is associated with an increased risk of tendon rupture.
The risk of developing fluoroquinolone-associated tendinitis and tendon…
Commentary by Melissa Freeman, PGY-2
As summertime is just around the corner, many begin to evaluate whether their bodies are ready to expose what has been hidden under those bulky winter clothes. Between busy lives and an innate desire for quick results, people sometimes turn to over-the-counter diet pills for a slimmer physique. With recently banned products like Ephedra, consumers are looking for newer, more promising weight loss products. During a recent clinic visit, a patient asked me about my thoughts on diet pills…
