Practitioners who treat patients with chronic pain understand just how difficult management of that population can be. As of today, the evaluation of pain remains completely subjective; no lab tests or imaging studies can provide any meaningful insight into how much pain a patient feels. When the pain is severe and intractable, the only option becomes opioid analgesics, which have high potential for abuse and are laden with side effects ranging from constipation and sedation to respiratory depression, testosterone deficiency, and immuno-modulation. The trouble with opioids is that they must be ingested in an oral form with systemic absorption regardless of where the actual pain lies. Over the past few years, a quiet murmur has been rippling through the pain practitioner community about the possibility of dispensing morphine as a topical agent. Small scale clinical trials and animal models have shown some promise, and also raised some questions about this experimental approach. Read more →

Currently, biotechnology drugs make up 10 to 15% of the pharmaceutical market in the United States, and this sector is growing faster than any other class of drugs. Biotech drugs include recombinant DNA technology, monocolonal antibodies, and gene therapy, and these drugs are revolutionizing treatment of diseases and complex conditions that previously had an unmet clinical need. The field of biotechnology is relatively new, and these drugs were like something out of science fiction novels only a few decades ago. Today, they are a reality, but they have come at a cost. The expensive and time-consuming research and development process make the drugs necessarily pricey once they are available on the market. Read more →

Countless drugs are manufactured as generic equivalents to brand name counterparts. Generic drugs must be bioequivalent to the brand name drug, meaning that they contain the same active ingredient at the same dose, in the same dosage form, with the same route of administration. The rate and extent of availability of the drugs must also be identical. Brand name drugs and their generic equivalents are interchangeable, and have demonstrated the same therapeutic effectiveness in clinical trials. Generic drugs, however, may not contain identical inactive ingredients or have identical formulations, packaging, or appearance. Read more →

Drug manufacturers widely use prescription drug samples as a marketing tool. In 2004, drug samples accounted for approximately half of the pharmaceutical industry’s marketing budget, or $16 billion. An advantage, touted by pharmaceutical companies and some physicians, is that these samples are made available to low-income and uninsured patients, providing them with otherwise unaffordable medications. There is new evidence, however, that, not only do the samples not reduce drug costs and not go to the most disadvantaged patients, but there are also significant safety concerns with some drug samples. Read more →

Before you agree with the recent JAMA report that Ginkgo biloba did not prevent dementia, you may want to consider how the study was conducted and whether or not the conclusion researchers made was legitimate.

The study was a large-scale clinical trial on the effectiveness of Ginkgo in reducing the incidence of dementia and Alzheimer’s disease. Six medical centers participated with 3069 volunteers 75 years or older. Of the total number of volunteers, 2587 had no cognitive disorders and 482 had mild cognitive impairment. The volunteers were tracked for a median of 6 years and used either a placebo or 120 mg ginkgo extract twice daily. Read more →

Acute pain affects more than 25 million Americans each year, and is one of the primary reasons that people seek medical care. Acute pain may result from injury, trauma, surgery, or medical procedures, and can have significant emotional, cognitive, and sensory consequences. Though acute pain, by definition, is short-lived, it can have significant and detrimental effects on the patient’s quality of life and can lead to chronic pain if left untreated. Up to half of post-operative patients in the United States receive inadequate pain control. This leads to delayed mobilization and increased risk for deep vein thrombosis and pulmonary embolism. Read more →