Medications Archive

Medication errors and communication problems may put people at risk.

It's been 20 years since the Institute of Medicine published its landmark report To Err is Human. It found that as many as 98,000 people were dying each year from preventable medical errors, prompting an industrywide patient safety effort that has spanned the past two decades.

An editorial published in JAMA Dec. 29, 2020, notes that in the years since that report came out, hospitals and doctors have made numerous changes that have succeeded in reducing preventable problems, such as hospital-acquired infections, falls, and medication-related errors. But more work remains to be done. Mistakes still happen.

Here's how to prepare for spring and summer pollen allergies.

Ah, spring is in the air. But unfortunately, so are billions of pollen particles that make millions of stuffed-up Americans suffer through weeks and months of sneezing, coughing, and wheezing. Even if spring and summer allergies never bothered you before, it's possible for symptoms to suddenly appear now in your 60s or 70s.

"Your immune system changes over time. Although most allergies begin early in life, it's possible to develop seasonal allergies at any age," says Dr. Mariana Castells, an allergist and immunologist in the department of Allergy, Rheumatology, and Immunology at Harvard-affiliated Brigham and Women's Hospital.

Research we're watching

While opioid use disorders have gotten a lot of attention in recent years, the number of people dying as a result of methamphetamine use is on the rise. A study published Jan. 14, 2021, in The New England Journal of Medicine found that a combination drug therapy may provide some hope in helping people with this difficult-to-treat disorder.

In the trial, half of the 403 adult volunteers were given a combination of two drugs: naltrexone, which is used to treat both opioid and alcohol use disorders, and bupropion, an antidepressant. The other half of the group received a placebo. The treatment period began in 2017 and ended in 2019. During that time people were given periodic urine tests to gauge whether they used methamphetamines. Those who had at least three of four drug-free tests were defined as having responded to treatment. Researchers found that by weeks five and six, 16.5% of the treatment group had responded to treatment, compared with 3.4% of the control group. By weeks 11 and 12, 11.4% of the treatment group met the urine test criteria for successful treatment, compared with less than 2% of the control group. Most people who received the drug treatment didn't have any serious side effects.

Whether you've had a stent placed or may need one in the future, here's what you should know about these tiny devices

Close to a million heart stents to open blocked or narrowing arteries are implanted each year in the United States, and as you age, the odds rise that you'll end up on the list of recipients.

"Getting a stent can save your life during a heart attack, but what you do after the procedure can dictate your future heart health," says Dr. C. Michael Gibson, a cardiologist with Harvard-affiliated Beth Israel Deaconess Medical Center.

Lifestyle changes — along with other proven therapies — can help improve these often-overlapping conditions.

Everyone goes through periods of feeling gloomy, irritable, or listless at least once in a while. And these emotions are perfectly normal after a diagnosis of a serious health problem such as heart disease. But if those unpleasant feelings drag on for weeks and gradually erase your sense of well-being, you may have depression.

Over a lifetime, about one in five Americans is affected by depression. But the risk of depression in people who've had a heart attack is three times as high as the risk among the general population.

Many cases of memory loss aren't related to dementia, but stem from other, treatable conditions.

You've been forgetting things lately — your keys, or maybe names. Sometimes you struggle to find the right word in conversations or repeat yourself to others. You may worry: are these signs of dementia?

If this sounds like you, you're not alone. Many people find their way into Dr. Tammy Hshieh's office wondering the same thing. But most of the time, it's not dementia causing their problems, says Dr. Hshieh, a geriatrician at Harvard-affiliated Brigham and Women's Hospital and Dana-Farber Cancer Institute and assistant professor of medicine at Harvard Medical School.

Grapefruit can mean danger when combined with some popular drugs used for high blood pressure, high cholesterol and depression

Grapefruit and grapefruit juice are healthful, providing enough vitamin C, potassium, dietary fiber, and other nutrients to earn the American Heart Association's "heart-check" mark. That's the good news. The bad news is that grapefruit juice can interact with dozens of medications, sometimes dangerously.

Doctors are not sure which of the hundreds of chemicals in grapefruit are responsible. The leading candidate is furanocoumarin. It is also found in Seville (sour) oranges and tangelos; although these fruits have not been studied in detail, the guidelines for grapefruit should apply to them as well.

On call

Q. I had a major heart attack earlier this year and received a drug-eluting stent. My doctor tells me that it's now safe to exercise and engage in sexual activity. But is it safe to use erectile dysfunction (ED) medications?

A. Most men who have recovered from a heart attack can resume their usual sex life. Once your doctor allows you to engage in moderate aerobic activity — sexual activity is often equated to the exercise level of brisk walking — you may safely use ED medications with certain precautions.

Ask the doctors

 Image: © scyther5/Thinkstock

Q. I've read that getting the flu shot annually will weaken my immune system over time. Is this true?

A. A study published in the March 1, 2017, issue of The Journal of Infectious Diseases investigated whether getting an annual vaccination against influenza (flu) can weaken your body's natural ability to protect itself from the disease. Past studies have raised similar concerns. Researchers at the University of Bergen in Norway followed 250 health care workers. Some of them got a flu vaccination every year from 2009 through 2013. The others only received the vaccine once in 2009 and not in the years from 2010 to 2013. The researchers then took blood samples before the influenza season (and before people were vaccinated that season), from the members of both groups and looked at different markers to gauge how well their immune systems would respond to the influenza virus. They found that getting an annual flu vaccination did not weaken the immune system. As a group, the people who got the flu shot annually appeared to have a better immune response to influenza than those vaccinated only once.

On call

Q. What is the significance of mild narrowing of the carotid artery detected by an ultrasound? I have never had any symptoms of stroke.

A. "Mild" narrowing ranges from 15% to 49% blockage of the artery. Over time, this narrowing can progress and lead to a stroke. Even if it doesn't progress, mild narrowing is a sign of early blood vessel disease and calls for preventive measures.