Spinal Corticosteroids Run Risk of Severe Neuro Effects

Epidural injections of corticosteroids to relieve pain — a widespread, off-label use — run the rare risk for blindness, stroke, paralysis, and death, the US Food and Drug Administration (FDA) announced today.

The FDA is requiring manufacturers of corticosteroids to revise drug labels to include this warning.

In today's announcement, directed at anesthesiologists and pain management physicians, the agency said it has not established the effectiveness and safety of epidural administration of corticosteroids such as hydrocortisone and methylprednisolone. As a consequence, "the FDA has not approved corticosteroids for such use."

>READ MORE for advising from the FDA at medscape.com

Reduced Salt Intake Lowers BP, Improves Stroke and Heart Disease Mortality Rates

LONDON, UK – Efforts to reduce salt intake in the UK are likely to have contributed to a significant reduction in blood pressure as well as ischemic heart disease (IHD) and stroke mortality over a recent eight-year period, according to a new analysis^[1].

From 2003 to 2011, average salt intake declined 15% and systolic blood pressure declined by 2.7 mm Hg in individuals not taking antihypertensive medications. Over the same time period, there was a significant 42% reduction in stroke mortality and 40% reduction in IHD mortality, report investigators.

>READ FULL REPORT from medscape.com

NSAIDs: Not as Safe as You May Think

A survey of over 9000 patients published in 2005 concluded that over-the-counter (OTC) analgesics, including nonsteroidal anti-inflammatory drugs (NSAIDs), are widely used, frequently by patients who are generally unaware of the potential for dangerous adverse side effects.^[1] Given recent concerns about use of acetaminophen products, particularly products with 500 mg or more per tablet,^[2] and the potential that patients will turn to NSAIDs as an alternative, it is more important than ever that clinicians provide accurate education about their use. Medscape spoke with Bill H. McCarberg, MD, founder of the Chronic Pain Management Program at Kaiser Permanente in Escondido, California, and a board member of the Alliance for the Rational Use of NSAIDs, about the latest evidence regarding these ubiquitous products.

READ FULL ARTICLE for more detail about side affects for GI damage and CV events from medscape.com

Don't Let Medicines Cause Harm

We take more medicines than ever to maintain or improve our health. But over the last decade, many baby boomers and seniors have ended up in the hospital because the medications they expected to help them actually hurt them.

Many medical problems now can be treated with medicines that were not available just a few years ago. But taking more medicines can also result in some unexpected reactions, especially for people who take several drugs. Bad reactions to medications are on the rise, according to a new report by my agency, the Agency for Healthcare Research and Quality (AHRQ).

Between 1997 and 2008, hospital admissions doubled among Americans aged 45 and older for medication and drug-related conditions. These hospital admissions include the effects of prescription and over-the-counter medicines as well as illegal drugs.

This increase has been driven by three types of medication and drug-related conditions:

Drug-induced delirium, which is general confusion and agitation caused by drugs. Common causes are drugs for sleeping, nausea, and pain. Elderly patients are more sensitive to medicines than younger adults.

Poisoning or overdose from codeine and other narcotic medicines. Bad reactions from narcotic pain medicines are especially common in older adults.

Withdrawal from prescribed medicines or illegal drugs. Drug withdrawal occurs when someone suddenly stops or takes much less of a drug after being on it for a long time.

via Navigating the Health Care System: Don't Let Medicines Cause Harm.

Popular Antibiotics May Carry Serious Side Effects - NYTimes.com

Antibiotics are important drugs, often restoring health and even saving lives. But like all drugs, they can have unwanted and serious side effects, some of which may not become apparent until many thousands of patients have been treated.

Such is the case with an important class of antibiotics known as fluoroquinolones. The best known are Cipro (ciprofloxacin), Levaquin (levofloxacin) and Avelox (moxifloxacin). In 2010, Levaquin was the best-selling antibiotic in the United States.

But by last year it was also the subject of more than 2,000 lawsuits from patients who had suffered severe reactions after taking it.

Part of the problem is that fluoroquinolones are often inappropriately prescribed. Instead of being reserved for use against serious, perhaps life-threatening bacterial infections like hospital-acquired pneumonia, these antibiotics are frequently prescribed for sinusitis, bronchitis, earaches and other ailments that may resolve on their own or can be treated with less potent drugs or nondrug remedies — or are caused by viruses, which are not susceptible to antibiotics.

via Popular Antibiotics May Carry Serious Side Effects - NYTimes.com.