And Then There Are Just Mistakes. Yikes!!

Sometimes the problem is not side effects, poor research, or slick marketing; sometimes simple but deadly mistakes are made in the hustle and bustle of hospital life. Here is an intro with link, to a piece from Forbes on Hospital Risks.

Duncan



Scariest Hospital Risks
Matthew Herper and Melanie Lindner 08.25.08, 4:15 PM ET

Hospitals manufacture miracles by the millions. They can also be hazardous to your health.

According to The Institute of Medicine, a non-profit organization chartered by the U.S. National Academy of Sciences, at least 1.5 million Americans fall prey to hospital error every year.

"Errors will happen anytime you take a complex system and put human beings inside of it," says Dr. Brent James, vice president of medical research and executive director of Salt Lake City's Intermountain Institute for Health Care Delivery Research. "The notion that you can train doctors to completely avoid mistakes is just false."

The mistakes aren't exactly minor, either. Between 40,000 and 100,000 people die every year because of shoddy handiwork, including surgical mishaps and drug mix-ups. One big problem: Hospital patients may get the wrong drug one time out of five, according to a study by Auburn University. The death toll from mistakes is at least as bad as that from car accidents or breast cancer, and maybe as bad as that from strokes.....follow the link for more



http://www.forbes.com/2008/08/25/hospital-risk-pneumonia-ent-manage-cx_mh_0825riskhospital_print.html

http://snipurl.com/3ke6b

Doctors, Marketing, and Money = Messy

Here is a item from CNN on physicians, money, marketing and ties to pharmaceutical and medical device companies. We, of course, would like to believe that all physicians are objective and only interested in our welfare. I wish it were true but sometimes........... Duncan


ATLANTA, Georgia (CNN) -- Linda Lewis says that when she had back surgery two years ago, her surgeon didn't do what was best for her health; he did was best for his bank account.
If Linda Lewis had known of her surgeon's financial ties to a device maker, she'd have sought a second opinion.

If Linda Lewis had known of her surgeon's financial ties to a device maker, she'd have sought a second opinion.

Lewis, a graduate student who lives in Sherman Oaks, California, says Dr. John Regan, a surgeon in Beverly Hills, put in an artificial disc to help relieve her lower back pain.

"He said my back would be better than ever," said Lewis, 45. "I'm thinking, 'Wow, disc replacement is the best thing since sliced bread.' "

But after the surgery, Lewis says, she ended up in debilitating pain, could walk only with the assistance of a walker and had to have a second procedure to correct the first one.

"I couldn't take enough drugs for the pain," she said. "Having that surgery was the worst decision of my life."

Lewis said she was "livid" when she later found out that Regan had financial ties to the company that makes the disc, saying she believes that those ties prompted Regan to recommend the disc over other treatment options.

In an e-mail to CNN, Regan's office manager said he "is not available for comment."

How likely is it that your doctor has a tie to a company that makes drugs or devices? Very likely, according to Dr. Robert Steinbrook, who wrote an article on doctor/industry ties this month in the New England Journal of Medicine. Video Watch more on medical marketing and doctors »

"Most physicians in the United States have financial relationships with industry, ranging from the acceptance of meals to the receipt of large sums of money for consulting, speaking, or conducting research," he wrote.

For example, two physicians made more than $8 million each from Dupuy Orthopaedics Inc., which lists the payments on its Web site.

"Consumers should absolutely know where their doctor is coming from," said Steven Findlay, a health care analyst at Consumers Union. "Doctors think they won't be influenced by these financial relationships, but the research shows that they are.".........click on the link for the rest.


Don't become a victim of medical marketing - CNN.com

A No-good Rotten Pharma Joke

The devil visited a pharma rep's home office and made him an offer. "I can arrange some things for you, " the devil said. "I'll increase your income five-fold. Your cluster mates will love you; your docs will respect you; you'll have four months of vacation each year and live to be a hundred. All I require in return is that your wife's soul, your children's souls, and their children's souls rot in hell for eternity."

The rep thought for a moment. "What's the catch?" he asked.


(a tip of the hat to John at http://pharmamkting.blogspot.com/, this was originally about only a Merck sales rep)

HPV Vaccines Questioned

Here in Texas, Governer Rick Perry tried by fiat to make the HPV virus mandatory but such a howl of protest arose that he backed down.

As frequently happens, now that there has been some time to consider whether taking such a vaccine is really a benefit, there are some real doubts arising.

Here is part of an article in the New York Times to addresses some of the questions.

Duncan



Researchers Question Wide Use of HPV Vaccines
By ELISABETH ROSENTHAL

Two vaccines against cervical cancer are being widely used without sufficient evidence about whether they are worth their high cost or even whether they will effectively stop women from getting the disease, two articles in this week's New England Journal of Medicine conclude.

Both vaccines target the human papillomavirus, a common sexually transmitted virus that usually causes no symptoms and is cleared by the immune system, but which can in very rare cases become chronic and cause cervical cancer.

The two vaccines, Gardasil by Merck Sharp & Dohme and Cervarix by GlaxoSmithKline, target two strains of the virus that together cause an estimated 70 percent of cervical cancers. Gardasil also prevents infection with two other strains that cause some proportion of genital warts. Both vaccines have become quick best sellers since they were licensed two years ago in the United States and Europe, given to tens of millions of girls and women.

http://www.nytimes.com/2008/08/21/health/21vaccine.html?_r=2&adxnnl=1&oref=slogin&ref=health&adxnnlx=1219335271-x9SgZFwVczlgNJxDckKSUQ&pagewanted=print
Click this link for the rest of the story:
http://snipurl.com/3ig07

Fruit Juices that Interact with Pharmaceuticals

You have probably figured out that I am not a fan of pharmaceuticals especially for extended periods of time (like the rest of your life.) Nevertheless if you feel you need them, it is best if you have information on how. Duncan

More Juices Found to Affect Drugs'

Effectiveness: Study

Orange and apple join grapefruit on list of drinks that may pose problems

Posted August 19, 2008

By Kathleen Doheny
HealthDay Reporter

TUESDAY, Aug. 19 (HealthDay News) -- Grapefruit juice, long known to boost the absorption of certain medications, isn't the only juice that doesn't mix well with drugs, according to the Canadian researcher who first identified the ill effects of grapefruit juice.

Other common juices, including orange and apple, may limit the body's absorption of drugs, compromising their effectiveness, said David Bailey, a professor of medicine and pharmacology at the University of Western Ontario, in London, Ontario, Canada.

Bailey was expected to present his research Tuesday at the American Chemical Society's national meeting, in Philadelphia.

"The original finding is that [grapefruit juice] markedly boosts the amount of drug that gets into the bloodstream," Bailey said. He first reported that nearly 20 years ago when he discovered that grapefruit juice increased the body's blood levels of the drop felodipine (Plendil), used to treat high blood pressure.

Since the original finding, other researchers have identified dozens of other medications that could interact adversely with grapefruit juice, Bailey said.

Doctors traditionally warn against drinking grapefruit juice if you're taking certain medications for high cholesterol, high blood pressure and heart rhythm problems, according to the American Academy of Family Physicians.

In his latest research, Bailey found that grapefruit juice, as well as orange and apple juice, can lower the body's absorption of some medications. Those drugs include the anti-cancer drugs etoposide (Etopophos, Vepesid); certain beta blockers like tenormin (Atenolol) and talinolol (Cordanum), used to treat high blood pressure and prevent heart attacks; cyclosporine, which is used to prevent organ transplant rejection; and some antibiotics, including ciprofloxacin (Cipro), levofloxacin (Levaquin), and itraconazole (Sporanox).

Bailey also found that healthy volunteers who took the allergy drug fexofenadine (Allegra) with grapefruit juice absorbed only half the amount of the drug, compared with volunteers who took the medicine with water.

In each case, substances in the juices affected the absorption of the drugs. Some chemicals block a drug uptake transporter, reducing drug absorption; other chemicals block a drug metabolizing enzyme that normally breaks down the drugs, he said.

"We don't [yet] know all the drugs affected," Bailey said.

Michael Gaunt is a medication safety analyst at the Institute for Safe Medication Practices in Horsham, Pa. He said, "If this study holds true [in future research], you are going to have to warn people in a similar fashion" about other juices.

Gaunt's advice for now: "In general, it's safest to take medication with water."

Bailey agreed. If you opt for water, he said, "a glass is better than a sip. It helps dissolve the tablet." And cool water is better than hot, he added, because your stomach empties cool water faster, sending the medication on its way to the small intestine and finally the blood stream.

More information

To learn more about juice and medication interactions, visit the American Academy of Family Physicians

http://health.usnews.com/articles/health/healthday/2008/08/19/more-juices-found-to-affect-drugs-effectiveness.html

http://snipurl.com/3i5c6

http://health.usnews.com/articles/health/healthday/2008/08/19/more-juices-found-to-affect-drugs-effectiveness.html

Important Supreme Court Pharma Case to be Heard

In damage cases filed against pharma companies, many times the companies claim that they cannot be sued because the FDA approved the drug in question. Soon the Supreme Court will hear a case that wants consumers to be allowed to sue even if the FDA has approved a drug. This could be very interesting.

Not only are six current and formers editors of the New England Journal of Medicine supporting the consumers' right to sue but 47 state attorney generals and two former FDA commissioners are supporting the move as well.

Perhaps as a nation, we will soon formally recognize that the FDA cannot be relied upon to insure a safe pharmaceutical sysem.

Duncan

Here is a excerpt from a news article with link from Pharmagossip:

In a brief filed with the US Supreme Court, six current and former editors of the New England Journal of Medicine stated that consumers should be allowed to sue pharmaceutical firms for failing to warn about a drug's dangers, even if its prescribing information was approved by the FDA. The brief was filed in case being reviewed by the Supreme Court in which a jury awarded $6.8 million to a plaintiff who had her arm amputated after being injected with Wyeth's nausea drug Phenergan (promethazine).

http://pharmagossip.blogspot.com/

http://snipurl.com/3hfou

Why we can't depend on the FDA

Here is a succinct summary by Jim Edwards on why the FDA cannot be relied upon to police big pharma. Be sure to follow the link at the end because it has links to the GAO (Government Accounting Office) detailed reports on each of the points.



FDA's Most Embarrassing Moments
August 1, 2008

You can read them in detail here.

But here's a summary:

1. After rule-change that allowed consumer drug advertising, didn't hire enough staff to police consumer drug advertising.

2. Post-marketing monitoring no good. Why? FDA doesn't know how to do post-market monitoring.

3. Took 11 months to successfully execute an off-label violation warning letter.

4. Supposed to be inspecting foreign drug manufacturers, but, uh, can't speak foreign languages.

5. Decided that emergency contraceptive should not be available to under-age rape victims.

6. Although elderly people take most drugs, forgot to ask companies whether they had tested their drugs on the elderly.

This entry was posted on August 1, 2008 at 3:05 pm and is filed under Uncategorized.

http://jimedwardsnrx.wordpress.com/2008/08/01/fdas-most-embarrassing-moments/

http://snipurl.com/3fctw