Exercise Caution with Over-the-Counter Drugs

November 23, 2014

Because over-the-counter drugs are so easy to obtain, people sometimes mistakenly believe that they are always safe to use. However, much like prescription drugs, over-the-counter medications have side effects that may make them dangerous to users in certain circumstances.

Common Adverse Effects

According to the U.S. Food and Drug Administration, one of the most common adverse effects of non-prescription medications is drowsiness. This side effect can be dangerous in a number of situations. For example, some people may drive, operate heavy machinery or perform other tasks that require alertness while under the influence of an OTC medication that causes drowsiness. If an individual is adversely affected by the medication, he or she is more likely to fall asleep, make mistakes and cause accidents.

In addition to the side effects OTC medications cause, they can also interact with one another and/or with any prescription drugs the individual takes concurrently. These interactions range in severity from very mild to deadly. For example, some medications may simply enhance one another's side effects when used together, while others can raise the user's risk of arrhythmias, internal bleeding and other potentially-fatal complications.

Take Caution

All over-the-counter medications can cause side effects. However, according to the FDA, some of the most dangerous OTC drugs are:

  • Nausea medications
  • Medications designed to treat diarrhea
  • Antihistamines

If you must take any of these medications, you should try to take non-drowsy formulas whenever possible. If you cannot take a non-drowsy formulation of the drug, avoid driving, operating machinery or performing similar tasks until you know how you react to the medication. Regardless of the medication you choose, be sure to read all of the included information thoroughly before use.

If you are taking more than one medication, even if one or more of the drugs are available over-the-counter, ask your pharmacist about any potential interactions that may exist.

Source: http://www.reviewjournal.com/life/health/take-care-over-counter-drugs, http://www.news4jax.com/news/overthecounter-medication-dangers/29237540

Drug Interactions in Senior Patients:
Watch Out for these Warning Signs

November 18, 2014

With older Americans more likely to take a variety of medications to manage everything from high blood pressure to arthritis, they are also at increased risk for serious drug interactions. Drug-drug interactions occur when two or more medicines react with each other, causing unwanted side effects. This interaction may cause one medication to not work as effectively as it should, or increase the risk for serious side effects. For example, if you take blood thinners, like Warfarin, you should refrain from taking aspirin.

Learn the warning signs associated with the most common drug interactions, including the medications that are most likely to cause health problems.

NSAIDs (non-steroidal anti-inflammatories).
These medications reduce inflammation. Long-term use, however, can lead to a host of health problems, including an increased risk for indigestion, colon cancer, stomach ulcers, kidney problems and high blood pressure. Never take these drugs in conjunction with blood thinners.

Over-the-counter sleep aids and anti-histamines.
Over-the-counter medications like Tylenol PM and Benadryl contain the ingredient diphenhydramine. This is a type of antihistamine that can cause blurred vision, drowsiness, constipation, dry mouth and urination issues in older adults. Accidental overdose can occur if you take this drug with other medications that include similar ingredients, such as naproxen and ibuprofen.

Headache medications.
Prescription medications, like Fioricet and Fiorinal, as well as over-the-counter headache medications like Excedrin Migraine can actually “overuse” headaches if you take these medications too often. Signs of an overuse headache include getting headaches more than 15 days per month; you may need to work with your doctor to decrease your dependency on these medications.

Nasal sprays.
Over-the-counter nasal sprays make it easier to breathe by tightening the nasal blood vessels. In some cases, however, OTC sprays can actually cause swelling and congestion because they over-tighten the blood vessels. If you experience more congestion after using a spray, talk to your doctor about alternative therapy options.

Digoxin.
This common prescription heart medication is one of the biggest offenders when it comes to medication interactions. Digoxin can produce toxic effects in individuals who also suffer from kidney problems. If you have a thyroid disorder or electrolyte imbalance, talk to your doctor about these conditions before you take Digoxin.

Remember, medication can also interact with certain foods (e.g., a high calcium diet) or over-the-counter supplements. Talk to your doctor about any and all medications that you are currently taking.

Source: http://www.fda.gov/Drugs/ResourcesForYou/ucm163959.htm

Anti-Stroke Drug Increases Risk for Dementia

November 18, 2014

Is your medication increasing the risk for dementia?

Is your medication increasing the risk for dementia? According to the results from a new study investigating the long-term usage of the anti-clotting drug warfarin in conjunction with antiplatelet therapy using aspirin or clopidogrel, this medication may be increasing the risk. The study found that long-term overtreatment with this combination of medication could increase the risk of dementia in these patients. Here’s what you need to know.

Over-Prescription Linked to Increase Risk for Dementia

The dual drug regimen of warfarin and aspirin is commonly prescribed by doctors to reduce the risk for strokes in individuals with coronary artery disease or peripheral vascular disease. According to the latest study, presented at the American Heart Association’s Scientific Sessions 2014 and reported in Medical News Today, individuals who were over-treated with these drugs were 25 percent more likely to be diagnosed with dementia when compared with individuals were not over-prescribed. The study measured blood-clotting times to determine whether an individual’s medication was being over-prescribed. Abnormally low blood clotting times were linked to the increased risk for dementia. None of the individuals involved in the study had a previous history of dementia.

"The dual drug regimen is often used to prevent strokes in people with coronary artery disease or peripheral vascular disease, but we have to consider that long-term exposure to anti-clotting drugs such as warfarin,” said lead study author Dr. T. Jared Bunch.

Study Recommends Alternative Stroke Prevention Measures

The study recommends alternative stroke prevention methods for keeping patients healthy. For example, study authors recommend new anti-clotting drugs that are easier to regulate than warfarin and are not associated with an increased risk for dementia. Additionally, a device can be inserted into the heart to restrict the formation and movement of blood clots in patients with atrial fibrillation (AF).

Individuals who are currently taking warfarin should talk to their medical providers about their current drug regimen. Dementia is a serious problem and long-term over treatment should be avoided whenever possible. More than 5 million people aged 65 and older have Alzheimer’s, the most commonly diagnosed form of dementia in the United States. Every 67 seconds someone in the United States develops the disease. Dementia diagnosis is expected to escalate rapidly in the coming years as members of the Baby Boomer generation continue to age. While medication can make a big difference for our quality of life, it's important to be aware of the different interactions and potential long-term health complications.

Lipitor and Diabetes
Growing concern over statin link to DM

November 17, 2014

About Lipitor

Lipitor, which is also known by its generic name "atorvastatin calcium," is a drug prescribed to lower cholesterol among patients with higher-than-normal blood cholesterol levels. The drug works by decreasing the amount of cholesterol the liver produces, thus reducing the risk of heart disease. It has been on the market since 1996.

More than 1,300 lawsuits are now currently pending in U.S. courts against Pfizer, the manufacturer of the popular cholesterol medication Lipitor. Filers of the lawsuits state that Lipitor has caused patients to develop type 2 diabetes. Filers also allege that Pfizer was aware of this risk but failed to warn users.

Understanding the Connection

According to the Journal of the American Medical Association, drugs belonging to the "statin" category, including Lipitor, have been linked to an increased risk of type 2 diabetes. Researchers believe that this occurs because atorvastatin calcium and other statins interfere with insulin signaling by blocking a specific immune response pathway. Statins have also been shown to promote insulin resistance and inflammation in mice.

If Lipitor does in fact contribute to the development of type 2 diabetes, the risk to users is significant. Type 2 diabetes causes the body to become insulin resistant, which means that it loses the ability to process insulin like it should. Over time, the body is cannot produce enough extra insulin to compensate, and blood sugar levels rise above normal. This causes a number of symptoms, including delayed healing of wounds, frequent infections, increased thirst, frequent urination and more. If left untreated, type 2 diabetes can also lead to complications, including skin conditions, hearing impairment, foot damage, eye damage, kidney damage, nerve damage, heart disease and an increased risk of Alzheimer's disease.

Risks for Future Patients

At the time of publication, Lipitor remains on the market and is still prescribed to patients. Litigation is ongoing, as plaintiffs continue to seek restitution from Pfizer. As of February 29, 2012, Pfizer and other manufacturers of statins were required to place a warning on their drugs in order to alert users to the connection between statins and type 2 diabetes.

Because the drug now contains a warning label, future users will not be able to bring legal action against Pfizer if they develop type 2 diabetes. Patients who choose to take the drug in spite of the warning should take the minimum effective dosage and be vigilant for signs of type 2 diabetes.

 

Source:
http://www.inquisitr.com/1611395/lipitor-cholesterol-drug-lawsuits-continue-to-mount-in-u-s-courts/, http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/complications/con-20031902, http://www.prweb.com/releases/lipitor-lawsuit/lipitor-diabetes/prweb12329216.htm, http://jama.jamanetwork.com/article.aspx?articleid=1892232

INDUCED HERPES ZOSTER:
IS FLUVOXAMINE THE CULPRIT?

November 15, 2014

FactMed Citation: World Journal of Pharmaceutical Research

Herpes zoster (HZ) also known as Shingles is an acute viral infection results from reactivation of the DNA virus varicella zoster (VZV) which causes chicken pox. HZ is a localized, generally painful cutaneous eruption that occurs most frequently among older adults and immuno compromised patients. The most commonly affected dermatomes are the thoracic (45%), cervical (23%) and trigeminal (15%). The risk factors of HZ are older age, immunosuppressed individuals, diabetes, female gender, genetic susceptibility, mechanical trauma, recent psychological stress and white race. Fluvoxamine is the drug which acts by inhibiting the serotonin reuptake and has immunomodulatory action. Here we presenting a rare case report of drug induced herpes zoster in a 58year old female patient suffering with obsessive spectrum disorder.

Tramadol and
Disseminated Intravascular Coagulopathy:
A Case Report

November 14, 2014

FactMed Citation: Medicine Science

Disseminated intravascular coagulopathy (DIC) is a clinicopathologic syndrome characterized by widespread intravascular fibrin formation in response to excessive blood protease activity that overcomes the natural anticoagulant mechanisms. The aetiology of this syndrome is different. In some instances it results due to drug such as cocaine in this report we report a case of DIC due to tramadol which is very rare.

Acute hepatic injury with atorvastatin:
An unusual occurrence

November 12, 2014

FactMed Citation: Indian Journal of Pharmacology

Atorvastatin, a commonly used and well-tolerated hypolipidemic drug, belongs to the class of statins or hydroxymethylglutaryl-coenzyme A reductase inhibitors. Use of atorvastatin may be associated with minor asymptomatic elevations in serum aminotransferases, but clinically significant hepatotoxicity is usually infrequent. Here we present a case of self-limiting clinically apparent acute hepatic injury attributable to atorvastatin occurring at recommended daily dose of 20 mg once a day. This case was postulated to be an unusual idiosyncratic reaction of the drug.

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