Medications Archive

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Newer medications, which may be safer than earlier drugs, have expanded the options for treating obesity.

Obesity is now considered more than a risk factor for other conditions; it's a disease itself. It has been the subject of intense scientific and medical research to develop effective treatments. But the quest has been elusive.

The Surgeon General has issued an advisory recommending that people carry and know how to use naloxone, and although it is an effective treatment for overdose, it does not address the larger issues around the opioid crisis.

Do these heavily promoted hormones justify the claims made for them?

"Bioidentical" hormones have been promoted as safer and more effective than FDA-approved hormones. The exaggerated claims go beyond relief of menopausal symptoms, suggesting they are a veritable fountain of youth.

It's understandable that women would be interested in a different approach now that long-term use of conventional hormone therapy (HT) does not prevent cardiovascular disease as researchers had hoped.

You may need to stop taking blood thinners, certain painkillers, herbs, and supplements to reduce your risk for bleeding.

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No one wants to have surgery, even minor surgery, but sometimes minor procedures, such as a tooth extraction or a colonoscopy, are unavoidable. When that happens, you may hear that it's important to stop taking certain medications. Understanding exactly which drugs to suspend — and when — can be confusing. "I get a lot of questions about this," says Joanne Doyle Petrongolo, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

Blood thinners

All surgery involves cutting body tissue, and that leads to bleeding. Blood thinners—medications like anticoagulants and antiplatelet drugs—can boost the risk for bleeding by keeping the blood from clotting.

Ask the doctor

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Q. I was recently diagnosed with long QT syndrome, which was apparently caused by a medication I was taking. But I understand that there are also genetic causes for this problem. Can you tell me more about this disorder?

A. Long QT syndrome is a rare disorder of the heart's electrical system. Electrical signals coordinate your heartbeat, telling the heart to contract and relax to pump blood. After each beat, the heart's muscle cells are busy recharging themselves for the next contraction by moving sodium, potassium, and calcium through tiny pores on their surfaces.

New medications and side effects warrant an evaluation.

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A medication regimen isn't something you can set and forget. You and your doctor need to keep tabs on what you're taking and how it's affecting your health. "We are required to do a medication 'check-up' at every visit, regardless of the specialty, which means that every clinician who sees you is supposed to review your medications and check off a box," says geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School.

Sometimes things change between visits, and adjustments need to be made. It's up to you to schedule an appointment. Here are seven reasons why that may need to happen.

Research we're watching

Cholesterol-lowering statins may be underused in younger people at risk for heart attack, new research suggests.

The study, in the Jan. 23, 2018, Journal of the American College of Cardiology, included more than 1,600 people ages 50 and younger who had experienced a heart attack. Only one in eight was taking a statin before the heart attack.

On call

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Q. I am about the same age as President Trump, and I also had a recent physical. My LDL (bad) cholesterol reading was 136, which my doctor thought was too high. But Mr. Trump's doctor said his LDL cholesterol of 143 was "excellent." Which is it?

A. The report of President Trump's health status brought out many armchair cardiologists — and real cardiologists — to comment on his cholesterol levels and risk for heart disease. The White House doctor's report stated that the president's "heart health" (not his cholesterol) was deemed excellent based on a normal exercise test and heart ultrasound. However, his LDL level of 143 was felt to be too high, and his doctor recommended doubling the president's statin medication. While the president doesn't show evidence of current heart disease, what is his future risk? A 71-year-old man with his cholesterol value would have a 10-year risk of heart attack, stroke, or cardiac death of 16% (about a one-in-six chance).

In the journals

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Migraine sufferers may be able to prevent future attacks with a new medication called galcanezumab, suggests a study published online Dec. 18, 2017, by JAMA Neurology. Currently, there are five FDA-approved drugs for migraines, but none were designed specifically for treating attacks or addressing the mechanisms at work.

In comparison, galcanezumab works to suppress the activity of calcitonin gene–related peptide (CGRP) in people. That molecule is believed to play an integral role in migraines and cluster headaches.

In the journals

A prescription cream called 5-fluorouracil (5-FU, sold as Adrucil and other brands) may help people reduce their risk for squamous cell carcinoma (SCC), according to a study published in the Jan. 3, 2017, JAMA Dermatology. SCC, the second most common cancer in the United States, strikes twice as many men as women.

Researchers recruited 932 people, 98% of whom were men, with an average age of 71. Each had experienced at least two skin cancers — SCC, basal cell carcinoma (BCC, the most common skin cancer), or both — on their face or ears within the past five years. They were randomly assigned to receive either the 5-FU cream or a placebo cream. Everyone applied a thin layer twice a day to their face and ears for up to four weeks. Over the course of a year, the 5-FU group had a 75% lower incidence of SCC compared with the placebo group. They also had a 11% lower incidence of BCC, but this difference was not statistically significant. It's not known why 5-FU helped prevent SCC but not BCC, according to the researchers.