Dr. Gustin's Blog

Breaking News: Dozens of Drugs to be Removed from the Market!

A committee of the European Medicines Agency (EMA) has just a few days ago recommended suspending the sale of roughly four dozen generic drugs that are used for conditions including diabetes, depression, and hypertension because they noted that their approvals were based on flawed clinical studies conducted only in India. The US Food and Drug Administration (FDA) has not yet taken action on the issue.  But they are in the process of reviewing this issue now.

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Another Statin Side Effect

Statins are one of the most popular drugs.  They reduce serum lipids implicated in producing cardiac and vascular disease.  Statins have side effects and are well-known, such as liver disease and muscle pain.  Now a new side effect has been discovered.

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Ecstasy Use Increases Dramatically

As Emergency Departments swell while suffering the repercussions of the Affordable Healthcare Act, our nation's youth increase their use of mind-altering drugs, in particular, Ecstasy (Mollys).

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Elevated Glucose in the ER

Over the past few years advancements have been made in the approach to, and management of, elevated blood glucose.  In the emergency room, elevated blood glucose (hyperglycemia) is commonly encountered.  Often times, patients who present with unrelated problems are coincidentally found to have elevated blood glucose.  Many emergency physicians dismiss this finding as a chronic finding and therefore, do not investigate further.  But this is a mistake that often results in an adverse patient outcome, and later a medical-legal inquiry and possibly a medical malpractice lawsuit.

Elevated blood glucose can be a tip-off that there are serious metabolic abnormalites present.  A detailed investigation is warranted in the ER because many of these patients are asymptomatic and will not seek follow-up medical care until they become symptomatic, by which time their condition may be far advanced.  The following review article on the approach to hyperglycemia in the ER is current and represents the standard of care approach to these patients.

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FDA Revises AMBIEN guidelines

Ambien is the most common sleeping medication at the present time.  Unfortunately, although Ambien is usually quite effective at facilitating sleep, it also has been found to have several disturbing side effects, including tolerance, addiction, and somambulism.  Recently the FDA has revised its dosing guidelines on how the medication should be used.  The news brief follows:

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Problems With Ambien

Ambien (zolpidem) is currently the most commonly used sleeping medication on the market. Most physicians believe, unknowingly, that it can be prescribed with impunity.  This is not the case.  Ambien has many side effects that have resulted in a big increase in visits to emergency departments.

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Amitiza for Opioid-induced Constipation

The FDA finally approved a new drug which ameliorates the severe constipation that accompanies the use of Opiates.  Constipation is one of the main side effects that causes individuals to stop Opiate medication prematurely without any other option for their pain.  This addition to treatment with opiates is a notable advancement.

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Zithromax and Sudden Death

At one time or another, most of us have taken the antibiotic, Zithromax.  It is one of the most commonly prescribed medications for conditions including bronchitis, pharyngitis, sinusitis, and others.  The discussion that follows has to do with Zithromax's side-effects, some of which are potentially life-threatening.  Recently, I have seen a case in my emergency room of sudden cardiac arrest secondary to the cardiac effects of Zithromax.  The FDA has recently warned of this phenomenon.

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2013 Review of Food Poisoning

The following article on food poisoning and foodborne outbreak disease was obtained from a recent issue of emedicine #175569.  It is an overview that covers major topics and issues.  It does not address travel medicine.  But it would have direct relevance to community acquired disease, assessments for such diseases, and surveillance.

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