Fosomax-type drugs linked to jaw necrosis

USC dentist links Fosomax-type drugs to jaw necrosis
Posted On: January 1, 2009 - 5:30pm

Researchers at the University Of Southern California, School Of Dentistry release results of clinical data that links oral bisphosphonates to increased jaw necrosis. The study is among the first to acknowledge that even short-term use of common oral osteoporosis drugs may leave the jaw vulnerable to devastating necrosis, according to the report appearing in the January 1 Journal of the American Dental Association (JADA).

Osteoporosis currently affects 10 million Americans. Fosomax is the most widely prescribed oral bisphosphonate, ranking as the 21st most prescribed drug on the market since 2006, according to a 2007 report released by IMS Health.

"Oral Bisphosphonate Use and the Prevalence of Osteonecrosis of the Jaw: An Institutional Inquiry" is the first large institutional study in the U.S. to investigate the relationship between oral bisphosphonate use and jaw bone death, said principal investigator Parish Sedghizadeh, assistant professor of clinical dentistry with the USC School of Dentistry.

After controlling for referral bias, nine of 208 healthy School of Dentistry patients who take or have taken Fosamax for any length of time were diagnosed with osteonecrosis of the jaw (ONJ). The study's results are in contrast to drug makers' prior assertions that bisphosphonate-related ONJ risk is only noticeable with intravenous use of the drugs, not oral usage, Sedghizadeh said. "We've been told that the risk with oral bisphosphonates is negligible, but four percent is not negligible," he said.

Most doctors who have prescribed bisphosphonates have not told patients about any oral health risks associated with the use of the drugs, despite even short-term usage posing a risk due to the drug's tenacious 10-year half life in bone tissue. Lydia Macwilliams of Los Angeles said no one told her about the risk posed by her three years of Fosamax usage until she became a patient of Sedghizadeh at the School of Dentistry. "I was surprised," she said. "My doctor who prescribed the Fosamax didn't tell me about any possible problems with my teeth."

Macwilliams was especially at risk for complications because she was to have three teeth extracted. The infection is a biofilm bacterial process, meaning that the bacteria infecting the mouth and jaw tissues reside within a slimy matrix that protects the bacteria from many conventional antibiotic treatments, and bisphosphonate use may make the infection more aggressive in adhering to the jaw, Sedghizadeh said. The danger is especially pronounced with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery. After her extractions, two of the three extraction sites had difficulty healing due to infection, Macwilliams said. Luckily, with treatment as well as the rigorous oral hygiene regimen USC dentists developed especially for patients with a history of bisphosphonate usage, the remaining sites slowly but fully healed. "It took about a year to heal," she said, "but it's doing just fine now."

Sedghizadeh hopes to have other researchers confirm his findings and thus encourage more doctors and dentists to talk with patients about the oral health risks associated with the widely used drugs. The results confirm the suspicions of many in the oral health field, he said. "Here at the School of Dentistry we're getting two or three new patients a week that have bisphosphonate-related ONJ," he said, "and I know we're not the only ones seeing it."

Source: University of Southern California

http://www.sciencecodex.com/usc_dentist_links_fosomaxtype_drugs_to_jaw_necrosis

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Dangerous Prescriptions- Frontline Program

In this Frontline Program, they are investigating our drug safety system. This program is from 2003 and years before the scandals with Vioxx, Celebrex, Avandia, and Paxil; nevertheless, the basic information and analysis of the problems in drug safety are still relevant. -Duncan



In "Dangerous Prescription," FRONTLINE® investigates the integrity of America's drug safety system. Through interviews with current and former FDA officials, critics, a pharmaceutical industry representative, and consumers, the one-hour documentary examines the FDA's handling of several drugs that were approved but later were pulled from the market after causing injuries and even deaths. The program also examines the role that drug companies play in the approval and monitoring of prescription drugs, and questions whether the FDA's current system is adequate for protecting the public.

http://www.pbs.org/wgbh/pages/frontline/shows/prescription/etc/synopsis.html

http://snipurl.com/35zh9

Gives a Whole New Meaning to "Sex and Drugs"

Here's a story from Jim Edwards' blog NRx. He gives some facts and figures on how SSRI's are having a devastating effect on people's sex lives. We have been going through all these years thinking about how sex and drugs were connected in a positive correlation(more drugs, more sex) when all of a sudden they have an negative correlation(more drugs, less sex).

Not to worry though. Another story of the day is about how a research study shows that if women taking Paxil are experiencing a rotten sex life, the solution is to take Viagra. A wonderful deal for Pfizer which just happens to manufacture both drugs. Ain't chemistry wonderful!!! -Duncan

Worst Side Effect Ever: The 'Pleasureless Orgasm'
July 21, 2008


File this one under "Why isn't this on the front page?!" It's a natural audience-grabber that actually has some proper science behind it:

SSRI antidepressants — such as Paxil, Lexapro, Zoloft, Luvox and Prozac — have rates of "decreased libido, delayed orgasm, anorgasmia, erectile dysfunction, and difficulties with arousal, of between 36 and 70%," according to a new study.

First reported on the excellent (but badly named) psychiatry blog "Clinical Psychology and Psychiatry: A Closer Look," the study is a comprehensive review of sexual side effects triggered by selective serotonin re-uptake inhibitors. (That's happy pills, for us lay-folk.)

One of the worst side effects, seemingly designed by the devil himself, is the "pleasureless orgasm." The condition goes hand in hand with "genital anaesthesia" (meaning "can't feel anything," presumably).

Let's do a little math: According to Scientific American, close to 10% of Americans are on antidepressants. Let's make it easy and say that's 30 million of 300 million yanks. Of those, possibly 23 million are walking around in a state of sexual frustration. And they have partners — so that's somewhere in the neighborhood of a possible 46 million of us who are inexplicably tetchy and bad tempered on most days. (Yes, I know that some of them will be dating each other — but you can see my point.)

http://jimedwardsnrx.wordpress.com/2008/07/21/worst-side-effect-ever-the-pleasureless-orgasm/

http://snipurl.com/33a84

Drugs, Seniors, Falling

All pharmaceuticals need to be analyzed completely including what their total effect on the patient is. In this case, the patients are elderly, a group for which falling can be quite devastating. I thank the folks at the Wall Street Journal Health Blog for this post.


July 16, 2008, 1:52 pm
Which Drugs Do — And Don't — Increase Fall Risks for the Elderly
Posted by Scott Hensley


Falls are the leading cause of injury deaths for people 65 and older, and they're the most frequent reason for trauma admissions among the elderly, according to the Centers of Disease Control and Prevention.

The drugs older people take can make them more susceptible to falling. That's why researchers at the University of North Carolina in Chapel Hill are mobilizing pharmacists in drugstores to advise older folks and their doctors on drug choices that could lower the risk.

While the first results of UNC's federally funded test of the approach won't be known until later this year, we caught up with some of the researchers on the project recently. The basic problem is that patients — and even their physicians — are unlikely to be aware of all the side effects that common medicines can have, Susan Blalock, an associate professor at UNC's pharmacy school, told us.

Drugs ranging from sleeping pills to painkillers can make people woozy, confused or interfere with balance. To cut the risk of falls, the UNC researchers are focusing on the options among nine groups of medicines. For a look at the best and worst choices by category, see the appendices to the study in the June issue of the American Journal of Geriatric Pharmacotherap


http://snipurl.com/302y5

Good Source of Drug Information

I find that I am going to www.drugs.com when I want to investigate pharmaceuticals. What I appreciate is their professional information which includes data comparing the side effects of particular drugs with the placebo.

Another valuable tool is their drug interaction feature. You need to register to use this but it is very simple to do so. Look for the link on the right of their homepage.

This is the best all around website for pharmaceutical information I have found so far, if you know of a better one or one that has additional information let me know. I promise I will check the sites you suggest.