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drugs

 by Victoria Santalesa

Choose Your Pain Relief Carefully

Pain. It can be overwhelming, and relief needs to be immediate. When discomfort gets hard to tolerate, most of us grab the first thing on the shelf of the medicine cabinet without thinking and herein lies the problem. Pain relievers are drugs, and like all other drugs, they need to be considered carefully before we take them. According to experts, many of the pains relievers in our medicine cabinets may be doing more harm than good. Here are what some of them are saying about NSAIDs and why other options should be on hand before pain hits.

Do Pain Relievers Put Us At Risk?
NSAIDS or Non-Steroidal Anti Inflammatory Drugs have been coming under fire lately for having the potential for cardiac risk. These drugs are commonly taken for relief of a variety of pain types, including headaches, muscle, Ibuprofen and joint aches. Examples include over the counter agents, such as Advil, Ibuprofen, alive, and Naproxen, while prescription varieties include Celecoxib and Celebrex. However, while former studies showed increased risk of heart attack, more recent ones reveal that the danger is more commonly associated with people who take the drugs regularly.

Studies reveal a two to fourfold increase in the risk of myocardial infractions for habitual NSAID users. That means that 25 to 50 patients would need to take NSAIDs for a whole year to cause one event of a stroke or heart attacks. However, because the use of the drugs is so popular, and many of the users are seniors who are already at risk for heart disease there is a cause for concern.

Highest Risk
The highest risk seems to come from taking over 750 mg of Naproxen or 1200 mg of Ibuprofen. Does this size is taken regularly carry a risk for GI bleeds, kidney injury, and stomach ulcers, in addition to cardiac risk.

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Thing to Keep In Mind
If you are young and in good health, your chances of cardiovascular complications caused by NSAIDs are small.

If you are currently at risk for heart disease, NSAIDs can increase the risk.

If you need to take NSAIDs on a regular basis, you should discuss the risks and possible alternatives with a health professional.

NSAID Alternatives
Because there is no one size fits all answer to pain relief, it is probably best to create a “Pain Plan” with your doctor or pharmacist. Considering the recent efforts to cut down on the use of opioids and increase the use of NSAIDs for arthritis treatment, careful decision making needs to go into picking the right pain relief.

While Tylenol, which is not a NSAID, is often a good pain relieving option, there are also no medication relief alternatives, such as the use of heat or ice, depending on the conditions. Although it is still safe for many patients to take NSAIDs, it is important to be aware of recommended dosages and the frequency of taking them. Experts recommend that no medication remedies, such as heat, massage, stretching, ice, and other forms of physical therapies be kept in consideration until more information is known.

Are you trading in your NSAIDs for other options? Let us know if you are and what they are.

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Pills and medicine on wooden table
 by Victoria Santalesa

What It Takes To Get A New Drug Approved

How many of us trust our federal government? According to Pew Research, only 19% of Americans today say they can trust our government to do what is right “just about always.” So, if we don’t know it we can trust our government, how do we know we can trust our government agencies? Take, for example, the FDA. While we’d like to think that the agency responsible for approving the drugs that we bring into our home and give to ourselves and our family holds itself to higher standards than the government for which it works, how can we be sure? Let’s take a look at the prescription drug approval process in the US to see just how trustworthy it is.

The Lowdown
According to a report published in the medical journal JAMA, 32% or FDA approved drugs already in use between 2001 and 2010 “were affected by a postmarket safety event,” meaning the safety of these drugs was questionable even though they had already been placed on the market. Events varied between announcements about recently discovered side effects to outright withdrawal of drugs due to reports of fatalities. In tandem with the release of this report comes the consideration by the Trump administration to streamline and shorten the approval process. According to internist Joseph Ross, one of the study’s authors, ” Our data show that there are some cautionary predictors of increased likelihood of the FDA taking a safety action in the postmarket setting. This information should be taken into account as the FDA considers conditions of approval and when further clinical trials should be required to better understand drug safety.”

Researcher working in lab

Revelations of the JAMA Investigation

  • Of the 222 FDA approved drugs 71 led to a safety event with three resulting in outright withdrawals. Sixty-one of these drugs qualified for “black-box warnings,” or warning labels posted on the packaging of the drug framed in black rule “designed to call attention to serious of life-threatening risks.”
  • Psychiatric treatment drugs and biologics that were given accelerated approval and drugs that got approval around the time of a regulatory deadline were most likely to require warnings after hitting the market.
  • These events highlight “the need for continuous monitoring of the safety of novel therapeutics throughout their life cycle.”

Especially affected by these findings are older Americans, as many of the drugs spotlighted in the study have potential risks that won’t come to light for years. For example, revolutionary treatments of ailments such as rheumatoid arthritis, cancer, and Crohn’s disease are among those currently being researched for the long-term impact on the population because accelerated approval drugs are considered more urgently needed, research about these drugs often takes a backseat and may not qualify for approval in time to meet the needs of more mature patients.

Implications
President Barack Obama signed the 21st Century Cures Act last December to speed up the approval process for certain drugs, a process President Donald Trump referred to as “slow and burdensome,” claiming it was hindering medical advances from reaching needy patients. According to Ross, “Speeding up approval even further will not be without consequence. There will be more uncertainty at the time of approval, endless that is known about a new therapy’s safety as well as its anticipated benefits.

Are you shocked by these findings? Not surprised? Let us know what you think and what you think should be done. We want to hear from you.

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Unhappy woman taking pills
 by Victoria Santalesa

Antibiotics May Be Linked To Miscarriage

According to the March of Dimes, up to 10% of expecting moms will get a urinary tract infection or UTI, during their pregnancies. Of these, about 25%, if left untreated, can develop into kidney infection, which can life-threatening for both mother and child. However, the good news is that as long as a UTI is caught early enough, it can be easily treated with antibiotics, right? Well, yes and no. While antibiotics can be a safe and effective treatment for UTIs, there are some new revealing studies that pregnant women will want to know about before taking them.

Antibiotics and Miscarriage
A recent study published in the Canadian Medical Association Journal has found some eye opening links between antibiotics and miscarriage in pregnant women. The prevalence of UTIs in pregnant women and their likelihood to be treated with antibiotics make this an issue of concern. A study done by researchers at the Universite de Montreal collected data from 182,369 pregnant women in Quebec between the years of 1998 and 2009, 8,702 of which ended in miscarriage before the 20th week of pregnancy. Of these, 16 percent occurred after the women took antibiotics.

Antibiotics to Avoid
Although all of this may be enough to scare you off antibiotics during pregnancy entirely, you should know that there are some medications which are higher risk than others. The most dangerous drug classes are tetracyclines, which is used as a treatment for acne, and quinolones, which can be used on a variety of infections, and was a common culprit in causing miscarriage, increasing its likelihood by three times. Clarithromycin, prescribed for pneumonia and bronchitis multiplies the risk by two. Azithromycin, used for infections of the respiratory system and some STIs, increased the of miscarriage risk by 60%, while metronidazole, used to treat bacterial vaginosis, increased the chances by 70%. Trimethoprim and sulfamethoxazole upped the risk by 25%.

Expert Advice
While it may seem as if there are no safe alternatives, Sherry Ross ob-gyn at Providence Saint John’s Health Center has some insight on the subject: If you notice symptoms of UTI, you definitely want to inform your doctor; if left untreated they can lead to preterm birth, kidney infection, and preeclampsia. Your doctor should recommend going with safer antibiotics, such as nitrofurantion, cephalosporin, penicillin, and erythromycin. All of these are safe antibiotics with a broad range of uses. Ross says, “Most important is to make sure you discuss the pros and cons of UTI options with your obstetrician and ways to avoid recurrent infections during the rest of the pregnancy, If you are trying to conceive and are unsure of your pregnancy status, you would want to make sure you are taking the antibiotics not associated with an increase in miscarriage risk.”

Have you experience UTI during pregnancy? How did you handle it? What’s your expert advice? Let us know!

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Woman checking pills
 by Victoria Santalesa

A List Of Items To Toss From Your Medicine Cabinet ASAP

Humorist and author Erma Bombeck once famously wrote, “My theory on housework is, if the item doesn’t multiply, smell, catch fire, or block the refrigerator door, let it be.” Operating on this logic, one could make a case for neglecting to clean out the medicine cabinet. After all, it’s highly unlikely you’ll find your antibiotics overrun with germs, right? Although there may be some attractive qualities to this theory, there may be some detriments to leaving your medicine cabinet unexamined for too long. The AMA recommends that you clean out your medicine cabinet once a year, and with spring cleaning upon us, this may be an ideal time. Here are some guidelines on doing just that.

What to Discard
Sara Bingel, PharmD, clinical pharmacist at Mount Sinai Hospital says, “In general, I would say many oral medications are safe to take a year or two beyond their marked expiration date.”

Items to save after expiration include pain relievers, allergy medications, like Benadryl, aspirins, stomach medications, like Tums, headache pills, and cold and flu pills.

Items to toss include itroglycerine for chest pain, life saving medications, antibiotics, liquid/suspension medications, and children’s meds.

Life-saving Drugs
When it comes to lifesaving drugs, it is crucial to heed expiration dates. The FDA requires medication manufacturers to find out how long it takes for drugs to reach a potency of 95%; after that, it is expired. That means that, when it comes to life saving meds, it’s all about getting the right amount into your body. Says Michael J. Negrete, PharmD., “I might be willing to roll the dice with cough syrup. It’s no big deal if the potency is down and it doesn’t help my cough. But imagine, with an Epi-pen, which keeps people from going into anaphylactic shock, not working.”

Woman at medicine cabinet

Store Meds Well
Expiration dates operate on the assumption that the unopened package is being kept in a cool, dry, dark place. While an untampered with package of Benedryl stored in a dark drawer in dry conditions is likely to be effective for years after its expiration date, one stored in a humid bathroom may be a very different story.

Take Visual Cues
When it comes to determining what to throw out of your medicine cabinet, there are some things you can judge for yourself. You don’t want to take a pill that crumbles in your hand and ineffective aspirin tends to smell like vinegar. Negrete advises that you, “Be suspicious of anything that looks out of the ordinary.”

Hold On To Solids, Lose the Liquids
Liquids, gels, and suspensions (in which the active ingredients is suspended in a liquid) tend to lose their potency more easily than pills and are also at risk of bacteria contamination, Bingel says, “Think rancid milk.”

Toss Children’s Meds
Paul Langevin, MD., director of cardiac anesthesiology at Waterbury Hospital comments, “Because children are smaller and their metabolic systems aren’t fully developed, I wouldn’t hang on to kids’ meds past the expiration date. Plus, a lot of medications for children are prepared in suspensions so the kids will take them and those flavored liquids can decompose and acquire bacterial growth.”

Are you cleaning out your medicine cabinet once a year? When the last time you went through your meds was.

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