This week the American Medical Student Association released its “AMSA PharmFree Scorecard 2009,” based on an evaluation of conflict-of-interest policies at 149 medical colleges and colleges of osteopathic medicine in the US, with a focus on interaction between students or faculty and the pharmaceutical industry
The methodology for the Scorecard was jointly developed by AMSA and the Pew Prescription Project, and assesses policies related to: “acceptance of gifts and meals from industry; consulting relationships; speaking relationships; disclosure of financial conflicts; pharmaceutical samples; individuals with financial conflicts participating in university purchasing decisions; financial support for educational events (on- and off-campus); industry support for scholarships and trainee funds; access of industry sales personnel to medical school or hospital personnel; and inclusion of education about conflict of interest within the academic curriculum,” according to a June 16, 2009, Executive Summary, on the AMSA website.
The presence of oversight and sanctions is also examined, “but not included in grade calculation,” the summary notes.
Of the 149 colleges, 35 schools, or 23%, received an F. Seventeen received a D, 18 were graded C, 36 schools received a B, and only 9 got an A.
Pregnant women are understandably cautious about what drugs and supplements they take-and this can be a problem for many women who suffer from debilitating morning sickness. What can you take that’s safe?
The New England Journal of Medicine (NEJM) published a new study this week, “The Safety of Metoclopramide Use in the First Trimester of Pregnancy“; Metoclopramide may sound familiar—it’s the name of the drug more commonly known as Reglan.
The results of the study are getting attention because the study, which was carried out in Israel, was apparently one of the largest of its kind to date. The results of the study were as follows:
There were 113,612 singleton births during the study period. A total of 81,703 of the infants (71.9%) were born to women registered in Clalit Health Services; 3458 of them (4.2%) were exposed to metoclopramide during the first trimester of pregnancy. Exposure to metoclopramide, as compared with no exposure to the drug, was not associated with significantly increased risks of major congenital malformations (5.3% and 4.9%, respectively).
Given that Reglan—which is typically prescribed for acid reflux (GERD)—was given a black box warning by the FDA earlier in the year for its connection to Tardive Dyskinesia (characterized by involuntary, repetitive movements of the extremities, lip smacking, grimacing, tongue protrusion, rapid eye movements or blinking, puckering, pursing of the lips, or impaired movement of the fingers), it’s hard to imagine taking such a drug while pregnant.
So it will be interesting to see what, if anything, the FDA will do based on the results of this latest study. For now, Reglan remains classified by the FDA as a Pregnancy Category B drug-meaning they don’t have enough information to determine if it does cause problems.
Nearly every year, researchers on drug company payrolls publish some ridiculous study with claims that more people may be dying from suicide due to a black box warning about an increased risk of suicide in young people on the labels of SSRI and SNRI antidepressants as a ruse to increase sales of drugs.
Judging from a new study out this month, with a June 2, 2009 headline on WebMD stating: “Are Antidepressant Warnings Causing Harm?”, apparently this year is no exception even though in the US there were 164.2 million prescriptions dispensed for antidepressants in 2008, compared to 143 million in 2004, according to IMS Health, a healthcare information company.
The study, published in the Archives of General Psychiatry, claims there has been a drastic drop in the diagnosis of depression in adults and kids.
So you’re pregnant, you’re heavy, you’re tired, and you’re suffering from indigestion and nausea quite badly. This is typically a situation beyond the ability of Alka-Seltzer to remedy. One of the medicines currently available to treat acid reflux (GERD) and nausea is Reglan, and it may be recommended to pregnant women in some instances, in the tablet formulation. The only problem is there’s a chance, slim perhaps, but still a chance your indigestion might be replaced by tardive dyskinesia—a movement disorder syndrome. And there’s also the question of what it could do to the fetus. So what should you do?
The potent and addicting drug Fentanyl is in the news again. This time a former nurse from Boulder, CO admitted to stealing the pain med for up to 290 patients in a Boulder hospital and replacing it with tap water or saline solution. Fentanyl abuse has been known in the health sector since at least 2004.
In August 2006 a wave of fentanyl-related overdose deaths made the painkiller headlines as the newest pharmaceutical to hit the streets, and with it came a rising demand. Two nurses fed that demand and both were convicted for illegal possession of fentanyl. (It makes you wonder how many people in the medical profession haven’t been caught.) No wonder fentanyl is the drug of choice: it has been estimated at roughly 100 times more potent than morphine. Consequently it has also been associated with many overdose deaths. Isn’t it time this drug was removed from the market?