Meningitis outbreak renews focus on drug safety
■ Selected articles on trends, challenges and controversies in the changing world of medicine.
Posted Oct. 22, 2012
Selected articles on trends, challenges and controversies in the changing world of medicine.
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The fungal meningitis outbreak linked to tainted steroid injections from a Massachusetts compounding pharmacy involves thousands of potentially exposed patients and about a dozen deaths so far. Congress has taken notice, and lawmakers on Capitol Hill are scrambling to conduct hearings and prepare legislation to beef up federal regulation of drug compounding.
American Medical News regularly covers the issue of drug safety and the role physicians can play in ensuring that patients receiving medications will not be harmed because of them. Despite such high-profile incidents as the meningitis outbreak — a problem that physicians could not have foreseen — drugs don't necessarily need to be tainted to be dangerous. Recent developments on the topic include new recommendations for doctors who prescribe certain drugs that frequently are misused, a federal opioid education plan for physicians and evidence that drug warnings too often are going unnoticed by doctors.
A study on adverse drug events concluded that physicians need to devote more attention to users of the medication therapies whose misuse causes the most medical problems. Warfarin, insulins, oral hypoglycemic agents and oral antiplatelet agents together account for seven in 10 emergency hospitalizations among seniors for adverse drug events. The study suggests six steps that physicians can take to order these drugs appropriately for seniors, educate them about their proper use and follow up to make sure instructions are being followed. Read more
Opioids can be powerful medical tools, but they carry the risk of fatal overdoses if misused. Newer versions of the drugs that come in extended-release or long-acting forms have raised the risks of such events. That's why the Food and Drug Administration released a blueprint for doctors to follow when prescribing such opioids. The FDA hopes that educating doctors more thoroughly will result in a better understanding of how to initiate patients on such newer therapies, make sure they take them correctly and get them off the regimens when no longer required. Read more
When a new side effect, drug-drug interaction or other unanticipated risk is discovered for a drug, the FDA tries to notify prescribers through new warning labels, advisories or even letters sent directly to physicians. But those communications too often don't make it to the professionals who potentially need to alter their prescribing practices. Conversely, the warnings are working too well in some cases; rather than leading to more appropriate prescribing, a knee-jerk reaction by doctors can mean that orders of the drugs cease altogether, even for the patients who still need them. Read more