Medications Archive

In the journals

Cholesterol-lowering statins and blood pressure drugs can improve heart health, but you still need to follow heart-healthy habits. That's the conclusion of a study published online Feb. 5, 2020, by the Journal of the American Heart Association, which found many people forgo healthy habits after they begin taking these medications.

Researchers in Finland identified 41,225 people who were free of cardiovascular disease. They collected such health data as body mass index, physical activity, alcohol intake, smoking status, and whether the people took statins or blood pressure drugs. Updated information was gathered from surveys every four years over a 14-year period.

Here's what the numbers mean — and strategies to lower your cholesterol if it's too high.

For some women who've had normal cholesterol readings all their lives, that changes at menopause. "Going through menopause often results in lipid and cholesterol changes for the worse," says Dr. Samia Mora, an associate professor of medicine at Harvard Medical School and a specialist in cardiovascular medicine the Brigham and Women's Hospital. Drops in the female hormone, estrogen, are associated with a rise in total cholesterol levels due to higher amounts of low-density lipoprotein (LDL), the "bad" cholesterol, and another blood lipid (fat) known as triglyceride. Over time this can raise heart risks, which is a reason for concern, as cardiovascular disease is the No. 1 cause of death in postmenopausal women, says Dr. Mora.

"So, it's especially important to track the numbers in perimenopause and the early years after menopause, as LDL cholesterol and total cholesterol tend to increase," she says.

Research we're watching

If you have children in your house — even for a few hours at a time — be certain to store your medications safely. A study in the January 27 issue of Pediatrics found that more than half of the time, accidental poisonings with prescription medication occurred because adults had removed the medicine from a child-resistant container before the child discovered it.

CDC researchers examined calls made between February and September 2017 to five poison control centers to determine how these accidents most often occur. Most of the time, the pills that children encountered belonged to a parent, but in more than half of cases involving particularly harmful medication, it belonged to a grandparent. These medications included drugs to treat diabetes or cardiac conditions. Child-resistant packaging can help protect children, but it's often inconvenient for adults. Study authors found that most often when poisonings occurred, it was because adults put the pills into pill organizers that were not child-safe, stored them in small plastic bags, or left them out on a surface that a child was able to reach. In other cases, a child found a pill that was dropped on the floor.

In the journals

Men often rely on drugs to manage overactive bladder symptoms, such as frequent urination, urgency, incontinence, and nocturia (having to use the bathroom at night). However, a study published online Jan. 13, 2020, by JAMA Internal Medicine suggests that adding behavioral therapy may lead to better results.

Scientists recruited more than 200 men (average age 64) with overactive bladder symptoms and divided them randomly into three groups. One group received only drug therapy. One received only behavioral therapy, which consisted of learning pelvic floor exercises and relaxation techniques to help suppress urges and prevent urine loss. The third group had both behavioral and drug therapy.

Memory slips are aggravating, frustrating, and sometimes worrisome. When they happen more than they should, they can trigger fears of looming dementia or Alzheimer’s disease. But there are some treatable causes of forgetfulness.

New studies shed light on the role of aspirin for people without a previous heart attack or stroke.

 Image: © dszc/Getty Images

It costs just pennies per pill, doesn't require a prescription, and may be lifesaving for some people. But daily low-dose aspirin doesn't make sense for everyone. Now, three major studies that examined the benefits and risks of this widely used drug may alter the advice about who should take aspirin.

"Aspirin remains a cornerstone of treatment after a heart attack or stroke. But the question of whether people with a low to moderate risk of heart disease should take aspirin is a really important one," says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital and professor of medicine at Harvard Medical School. Tens of millions of people in the United States fall into that low-to-moderate-risk category. But until now, there weren't many large trials that included those people, he notes.

Dozens of states are cracking down on the amount of opioids doctors can prescribe.

 Image: © Darwin Brandis/Getty Images

Overdoses of powerful painkillers called opioids kill more than 115 people per day in the United States. More than 42,000 people died from opioids in 2016, five times more than in 1999. The reason? Since several of these powerful painkillers became available in pill form several decades ago, doctors have been prescribing more than patients need. "It is estimated that a large part of leftover opioids are diverted to the street, either deliberately or through theft," says Dr. Edgar Ross, senior clinician at the Pain Management Center at Harvard-affiliated Brigham and Women's Hospital.

The misuse of opioids is a risk many states are no longer willing to take. The rules limit the amounts that medical professionals can prescribe for temporary (acute) pain from surgery, injury, or illness.

Which pain reliever should you take, acetaminophen or NSAIDs?

What you need to know about common pain relievers, from Tylenol to Aspirin. Once upon a time, easing pain was relatively simple: take two aspirin and call the doctor in the morning. Now there are many pain relievers to choose from (see "Pain relievers at a glance").

Willow bark was one of the earliest painkillers. Extracts or teas of willow bark have been used to treat fever and pain for more than 2,000 years. Unfortunately, the active ingredient, salicylic acid, is very hard on the stomach. In 1897, a German chemist working for the Bayer Company found a way to modify salicylic acid so it was less irritating to the stomach. The compound he created, acetylsalicyclic acid, was called Aspirin. It remained the premier over-the-counter painkiller until the development of acetaminophen in 1956 and ibuprofen in 1962. Since then, more than a dozen others have come onto the market.

Some drugs that contain ranitidine (best known as Zantac) have been found by the FDA to have unacceptable amounts of N-nitrosodimethylamine (NDMA), a possible cancer-causing chemical (which also triggered recalls of certain lots of the blood pressure drugs called angiotensin-receptor blockers).

On April 1, 2020, the FDA requested that all forms of ranitidine (Zantac, generic versions), including prescription and over-the-counter products, be removed from the market. They may contain unacceptable levels of a potential cancer-causing substance known as NDMA, or N-Nitrosodimethylamine. In some samples tested by the FDA, the impurity appears to increase over time, especially when stored at higher temperatures. So far, tests of other acid blockers do not show this potential increased cancer risk. 

Cannabis use among older adults has been steadily increasing, due to lessening stigma and increased interest in using medical marijuana. But there are specific concerns for older people, so anyone considering this option should have a conversation with their doctor weighing the benefits and risks.