Pharmacology

Ethical Considerations on the Use of Fear in Public Health Campaigns

November 23, 2011
Ethical Considerations on the Use of Fear in Public Health Campaigns

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 …

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Medicine By Numbers: 131 Million

October 28, 2011
Medicine By Numbers: 131 Million

By Maryann Kwa, MD

Faculty Peer Reviewed

131 million: The number of times the most popular medication in the United States was prescribed in 2010.

Recently, IMS Health, a company that monitors annual sales for pharmaceutical and healthcare industries, published a list of the most prescribed medications in the United States in 2010 .

Medication Number of Prescriptions in 2010(in millions) 1. Hydrocodone/Acetaminophen 131.2 2. Simvastatin 94.1 3. Lisinopril 87.4 4. Levothyroxine sodium 70.5 5. Amlodipine 57.2 6. Omeprazole 53.4 7. Azithromycin 52.6…

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They’re all the ‘roid rage: origins and mechanisms of corticosteroid therapy.

September 23, 2011
They’re all the ‘roid rage: origins and mechanisms of corticosteroid therapy.

By Santosh Vardhana, MD

A 36-year-old obese male with hypertension and hyperlipidemia presents to the ER with new knee pain, swelling, and erythema.  Joint aspiration reveals negatively birefringent crystals.  He is started on oral prednisone.

A 26-year-old woman with lupus presents to ER with edema, hematuria, and fevers.  On exam she hypertensive, febrile to 100.4C, and has periorbital and lower extremity edema.  Urine dipstick reveals 2+blood and protein.  She is started on IV methylprednisolone.

A 60-year-old man with HIV on HAART presents to the ER …

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Avastin and the Meaning of Evidence

September 9, 2011
Avastin and the Meaning of Evidence

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 …

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More Pills, More Problems: The Polypill Revisited

August 3, 2011
More Pills, More Problems: The Polypill Revisited

By Jonathan Leventhal

Faculty Peer Reviewed

Polypharmacy has become an integral part of daily life for millions of chronically ill patients worldwide, and rightfully so. Evidence-based studies have repeatedly demonstrated that multiple drugs are required for optimal therapeutic management in chronic diseases including diabetes, hypertension, and heart disease. A typical patient with cardiovascular disease will likely be on aspirin, a statin, an ACE inhibitor, a diuretic, a calcium channel- or beta-blocker, and possibly antidiabetic medications. Cardiovascular disease is only one area in which effective …

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Low Dose Vitamin K Supplementation and Anticoagulation Control

July 21, 2011
Low Dose Vitamin K Supplementation and Anticoagulation Control

By Joanna Becker

Faculty Peer Reviewed

Patients who are placed on long-term warfarin (Coumadin) therapy are sent home with a lengthy list of restrictions to minimize variations in warfarin efficacy. The agents that can alter warfarin levels can be divided into 2 categories: (1) those that interact with cytochrome P450, which metabolizes warfarin and (2) those that alter phytonadione (vitamin K) levels.  The majority of inter- and intra-individual warfarin dose variability is attributable to the agents in category 1 above, which include everything from antibiotics, …

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Breaking News: FDA issues new dosing limitations for Simvastatin

June 10, 2011
Breaking News: FDA issues new dosing limitations for Simvastatin

By Saleem Ali, MD

The FDA has issued new warnings regarding the use of high dose Simvastatin. The FDA is now recommending that the 80mg dose only be used in patients who have been taking that dosage for at least 12 months with no signs of toxicity.  Patients who are currently on simvastatin and require more than 40 mg. should be considered for alternative lipid lowering therapy. The FDA is issuing this warning because recent data has shown that the 80 mg. dose has a …

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Resveratrol: The Modern Fountain of Youth?

February 9, 2011
Resveratrol: The Modern Fountain of Youth?

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 aging process in humans …

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