Medications Archive

Research we're watching

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A new test might help doctors better treat patients with urinary tract infections, according to a study published in the Oct. 4, 2017, issue of Science Translational Medicine. These infections prompt some eight million doctor visits each year, and doctors often prescribe antibiotics to treat the condition. However, sometimes the bacteria they are attempting to treat are resistant to first-line antibiotics. The delay caused by the ineffective medication can, in some cases, cause the patient's condition to worsen and lead to complications. To eliminate this antibiotic guesswork, researchers developed a new quick-acting antimicrobial susceptibility test that not only tells the doctor within 30 minutes whether the patient has a urinary tract infection, but also what type of bacteria caused it and what drugs will best treat it. The test can also quickly identify cases where antibiotics aren't needed at all, preventing overuse of antibiotics, which can promote resistance. The same type of rapid testing, might eventually be of use in identifying the best anti-biotics for other types of bacterial infections as well.

News briefs

People with coronary artery disease or strong risk factors for developing it are often treated with statin drugs. Statins were developed to treat high levels of LDL (bad) cholesterol, because such high levels increase the risk of coronary artery disease. Studies convincingly showed that statins do indeed reduce both cholesterol and the risk of coronary artery disease, as expected. However, a large Harvard study published in 2008 found that statins also lowered the risk even in people with normal LDL levels. Why? Many doctors speculated that the reason might be that statins also reduce inflammation, another contributor to heart attacks and stroke. A new Harvard study, published online August 27, 2017, by The New England Journal of Medicine used a novel medication called canakinumab, which attacks inflammation but does not lower LDL cholesterol. The study involved over 10,000 people who had suffered a heart attack and whose blood showed a modest level of inflammation. The inflammation-fighting medicine lowered the rates of heart attacks, strokes, and death from heart disease. This study supports the theory that the beneficial effects of statins may result from their ability to both lower cholesterol and tamp down inflammation. It also will lead to further study of this new drug as well as other treatments for inflammation.

Avoid taking these drugs when they're not needed.

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It's the time of year again for sneezing, sniffling, and sore throats. But if you don't escape it, you can just head to the doctor for an antibiotic, and you'll be healthy again in no time. Right?

Probably not.

"Each year millions of Americans are treated with antibiotics when they don't need to be," says Dr. Erica Shenoy, an infectious disease physician, who is associate chief of the Infection Control Unit at Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School.

Ask the doctor

Q. I recently started taking low-dose aspirin, per my doctor's advice. But I heard that for some people, aspirin doesn't help prevent heart attacks. Is this true, and is there any way to find out if I'm one of those people?

A. The phenomenon you're referring to is sometimes called aspirin resistance. However, true aspirin resistance is very uncommon. There are tests for the problem, but I don't recommend them.

A novel anti-inflammatory drug may discourage repeat heart attacks.

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Inflammation grabbed the attention of researchers a couple of decades ago as a primary culprit in the progression of cardiovascular disease. However, identifying a drug therapy that leverages this link has been more elusive. With the results of the recent Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS), published in the Sept. 21, 2017, issue of The New England Journal of Medicine, it appears that the dots are finally beginning to connect.

"For the first time, we have an anti-inflammatory therapy that can reduce the chance that a person who has already had a heart attack will have a repeat occurrence," says Dr. Peter Libby, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. "This opens up a new field of treatment and offers hope to our patients." He is one of the co-authors of the study, which was led by his colleague and fellow Harvard Medical School professor Dr. Paul Ridker.

Research we're watching

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The ancient, mind-calming practice of meditation may have a role in reducing the risk of heart disease. So says a scientific statement from the American Heart Association in the Sept. 28, 2017, Journal of the American Heart Association.

Experts reviewed dozens of studies published over the past two decades. The results suggest that meditation may improve a host of factors linked to heart disease, including stress, anxiety, depression, poor sleep quality, and high blood pressure. It may also help people stop smoking. An added bonus: it's low-cost and poses no apparent risk.

Take advantage of free medications, blood pressure screenings, and exercise classes to stay healthy and save money.

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Medical costs are soaring, but not every step you take to improve your health has to cost an arm and a leg. Some services are even free, regardless of your financial need. "These are incredibly helpful, although few of my patients know about many of them," says geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School. The trick is knowing where to find the services, and this month we have suggestions on where to look.

Free exercise classes

Exercise is essential for overall health and mobility, especially as we get older. Many organizations support that by offering free exercise classes for older adults. Good places to find free classes: hospitals and senior centers. Give them a call, or look on the Internet to see an organization's event calendar.

It may help prevent a heart attack or stroke, but it comes with the risk of bleeding.

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Maybe you've heard about people who take a low-dose aspirin each day to ward off heart problems. Since aspirin is a medicine you've probably used now and then without a problem, and since it is available without a prescription, you might consider trying a daily low-dose aspirin yourself. Don't do it. Unlike deciding to take a multivitamin, taking a daily aspirin isn't something you should decide to do on your own.

Aspirin therapy is typically prescribed to people who have atherosclerosis of the arteries of the heart or brain, or risk factors for such disease. Just who should take a daily aspirin, how much aspirin, and what type of aspirin are hotly debated issues, with clinical trials under way in search of answers. "Until those results are in, you should talk to your doctor before starting aspirin," says Dr. Deepak Bhatt, a cardiologist and the editor in chief of the Harvard Heart Letter.

Ask the doctor

Q. My doctor added metoprolol to the diuretic medication I'm taking for my high blood pressure. Ever since then, I've felt more tired than usual, and my wife says I seem a little depressed. Could the new drug be to blame, and if so, is there anything I can do about it?

A. Metoprolol (Lopressor, Toprol) belongs to a class of drugs known as beta blockers. These drugs — which make the heart beat slower and with less force — used to be given as a first-choice treatment for high blood pressure. But they can cause fatigue and depression in some people, as well as other side effects, such as erectile dysfunction.