Medications Archive

Articles

Low LDL and stroke: A closer look

When it comes to understanding this link, the devil is in the details.

When we talk about LDL cholesterol, it's always described as bad or harmful — and with good reason. High blood levels of this artery-clogging substance boost the risk of heart disease, the nation's leading cause of death. The more you can lower your LDL cholesterol (through diet, exercise, or medications), the lower your risk of a heart attack. For heart attack survivors, national guidelines recommend aiming for an LDL cholesterol level of less than 70 milligrams per deciliter to prevent a second heart attack.

In the past year, however, two studies in the journal Neurology reported a higher risk of hemorrhagic (bleeding) stroke in people with LDL levels of 70 and lower. While that sounds worrisome, a closer look at the findings can put these results into perspective.

Gout drug may help prevent repeat heart attacks

Research we're watching

A drug long used to treat a painful form of arthritis called gout may also benefit heart attack survivors, according to a new study.

Derived from the autumn crocus, colchicine (Colcrys, Mitigare) helps to ease the joint inflammation and pain that characterize gout. Because mounting evidence suggests that inflammation plays a role in heart disease, researchers have tested various anti-inflammatory drugs in heart patients. The latest study, published online Nov. 16, 2019, by The New England Journal of Medicine, tested colchicine against a placebo in 4,745 people who had experienced a heart attack within the previous month. All the participants also took standard drugs to treat heart disease, including statins, aspirin, and other clot-preventing drugs.

Marijuana use linked to higher risk of stroke in younger adults

Research we're watching

Younger adults who use marijuana appear to face a higher risk of stroke compared with those who don't use the drug, according to a report published Nov. 11, 2019, in the journal Stroke.

Researchers pooled data from a nationally representative survey from the CDC that included nearly 44,000 participants ages 18 to 44. About 14% reported using marijuana within the past month. Young adults who recently used marijuana were 1.8 times more likely to experience a stroke compared with nonusers. The risk was 2.5 times higher among frequent users (more than 10 days a month). Frequent marijuana users who also smoked regular cigarettes had three times the risk for nonusers.

How long does a drug stay in my system?

On call

Q. I started having side effects from a prescribed drug. I stopped taking it, but the side effects are still there. How long does it take for a drug to be out of your system?

A. Most drugs will be out of your system quite quickly, but the symptoms of side effects may remain for some time. It depends on the medication and what kind of side effect has developed. The majority of prescription drugs are cleared out of your body rapidly by your kidneys and liver. Trace levels of a medicine may remain in the system while the liver and kidneys finish their filtering job. But these levels are often too low to have any noticeable effect. Patients with kidney or liver disease, however, can continue to have elevated blood levels of a drug even after stopping it.

Taking blood pressure medication at bedtime instead of the morning can reap greater health benefits

 

In the journals

People with high blood pressure may benefit from taking their antihypertension medication at bedtime instead of the morning, according to a study published online Oct. 22, 2019, by the European Heart Journal.

The researchers looked at about 19,000 people (most of them men) who took blood pressure medication. Participants took their daily dose either upon waking or before going to bed. Everyone's blood pressure was checked over 48 hours once a year for six years.

The growing problem of drug-resistant UTIs

Urinary tract infections can be dangerous. Here's how to recognize, treat, and prevent them.

More than 2.8 million antibiotic-resistant infections now occur in the United States each year, according to a CDC report published in November 2019. Among them are a growing number of urinary tract infections (UTIs) that can no longer be treated with the most common antibiotics.

"Antimicrobial-resistant UTIs are on the rise and have been since the early 2000s," says Dr. Lisa Bebell, an instructor in medicine at Harvard Medical School and an infectious diseases specialist at Massachusetts General Hospital. This trend is especially concerning for women because UTIs are so common: one of every two women will have a UTI in her lifetime.

Is nighttime the right time for blood pressure drugs?

Taking these medications at bedtime rather than in the morning may make them more effective.

Many people take their medications as part of their morning ritual, along with a cup of coffee and the daily newspaper. But for blood pressure drugs, evening may be a better option. Last year, a large study found that taking blood pressure drugs before bed may lower the risk of serious heart-related complications more than taking the drugs in the morning (see "Benefits of bedtime blood pressure dosing").

The concept of chronotherapy, or adjusting medication dosing to a specific time of day, isn't new. There's not a great deal of evidence to support the practice with cardiovascular drugs, but it makes sense, says Dr. Naomi Fisher, director of the Hypertension Specialty Clinic at Harvard-affiliated Brigham and Women's Hospital.

Tips to minimize the risks of anesthesia

Careful planning may help you avoid side effects.

It's always concerning when the doctor says you need a procedure that requires anesthesia. On top of worries about the procedure itself, you may wonder how you'll react to anesthesia, especially now that you're older. The answer is complicated.

Aging changes everyone's basic physiology. Anesthesia introduces some risk, but less so than the risk from underlying health conditions, the surgical procedure itself, and the care you receive after surgery," says Dr. Angela Bader, an anesthesiologist and founding director of the Weiner Center for Preoperative Evaluation at Harvard-affiliated Brigham and Women's Hospital.

5 common medications that can have serious side effects

Report new symptoms immediately if you take one of these.

Taking blood thinners and prescription painkillers such as opioids can have potentially life-threatening complications. But many medications — even over-the-counter drugs — have the potential for dangerous side effects. "In most cases, the risk of serious side effects is very rare — much less than 1% of the time," says Dr. Joshua Gagne, a pharmacist and epidemiologist with Harvard-affiliated Brigham and Women's Hospital.

If you're taking any of the following drugs, learn the rare risks.

FDA approves new migraine medication

Research we're watching

If you suffer from migraine headaches, there's a new option available to relieve your pain. In October 2019, the FDA approved lasmiditan (Reyvow) to treat migraine pain in adults. Taken as a pill, it works for migraines either with or without an aura (a visual disturbance within the hour before migraine pain starts). Lasmiditan is not designed to prevent migraines. Lasmiditan is the first migraine treatment in a class of drugs known as serotonin (5-HT) 1F receptor agonists. In studies, researchers found that it could relieve pain and other migraine symptoms within two hours.

Migraines affect an estimated 28 million women in the United States, according to the American Migraine Foundation, and the World Health Organization ranks them among the top 10 disabling conditions. Pain and other symptoms, which may include nausea, sensitivity to light and temporary vision changes, result in lost work days, reduced productivity, and diminished quality of life for many people.

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