Archive for drugs

Why are so many people on chronic medications?

Posted in Medicine, Uncategorized with tags , , , , on May 16, 2008 by Dr. CJ

A recent report revealed that over half of all Americans are on at least one medication on a chronic basis.  This analysis includes children and adults.

The article cites that medications for blood pressure and cholesterol are the most common.  Note that these problems are core features of the Metabolic Syndrome which is already at epidemic levels and steadily worsening.

Best line of the article:

"Honestly, a lot of it is related to obesity," he said. "We've 
become a couch potato culture (and) it's a lot easier to pop a 
pill" than to exercise regularly or diet. 

Another epidemic problem is the overdiagnosis of and over-prescribing of medications for so-called ADHD.  That calls for a separate post, if I dare, but no one can argue that so many children need medication to get through a school day.  That’s flat-out ridiculous and more an indicator of a parent’s ability to teach discipline and maturity than a “disorder” of the child. 

Certainly, there is also an influence from public education.  For example, I frequently see people who have either learned about their risk for certain medical conditions or about medications that are being advertised for these conditions, and this bit of awareness prompts them to initiate a discussion about it. 

There’s room for a long, complicated discussion about the necessity and ethics of pharmaceutical products being used on this scale.  As mentioned previously, I encourage patients to minimize their use of medications by addressing the important health factors

People want quick fixes, and especially easy fixes.  It still amazes me, yes, but people are far more willing to pay $30-100 / month and subject themselves to risk of liver disease, muscle injury, electrolyte depletion, and other side effects than to devote themselves to a regimen of healthy eating and regular physical activity to achieve the same results.

This report also begs the question: why are the doctors prescribing so much medication?  Aside from the obvious increase in chronic medical conditions like hypertension, hyperlipidemia, and diabetes; the philosophy of the physician is put to the test when confronted with these patients, as in drug vs. fitness.


Is simvastatin still a good drug?

Posted in Heart Disease with tags , , , on January 22, 2008 by Dr. CJ

There was a report released recently about simvastatin being less effective than one of the more experienced statins at reducing certain measures of cardiovascular risk, despite its ability to lower the LDL cholesterol (the “bad” cholesterol) levels. 

My first word of caution regarding this: the study was performed in a very select group of individuals, people with a genetic disorder contributing to markedly elevated cholesterol levels that affects less than 1% of the population.  Right off the bat, you would be hard-pressed to apply the results of this study to the larger population (not sure why they even bothered).

It very well may not be as effective at reducing cardiac risk as we once thought, but until there is a more clear answer it shouldn’t be shunned quite yet.  As a generic drug, it is cheap and most often quite effective at lowering the LDL.  I expect there will be more detailed outcome studies comparing simvastatin with other statins.