When you take two or more drugs, there is a chance that it would be the interaction between them. Interaction may increase or decrease the effectiveness of drugs or drug side-effects. The probability of drug interactions with increasing number of drugs taken increases. Therefore, people who take several drugs are in most danger. The survey focuses on the interaction of drugs and ways to avoid them.
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A healthy lifestyle is the first defense against high cholesterol. But sometimes diet and exercise aren’t enough, and you may need to take cholesterol medications. Cholesterol medications may help:
A stroke occurs when the blood supply to a part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within a few minutes, brain cells begin to die. Stroke is a medical emergency, and prompt treatment of a stroke is crucial. Early treatment can minimize damage to your brain and potential stroke complications. The good news is that strokes can be treated, and many fewer Americans now die of strokes than was the case 20 or 30 years ago. Improvement in the control of major risk factors for stroke — high blood pressure, smoking and high cholesterol — is likely responsible for the decline.
Watch for these stroke symptoms if you think you or someone else is having a stroke: Read the rest »
Two well-known HIV drugs, abacavir and didanosine, appear to increase the risk of heart attacks, European researchers reported Wednesday.
Based on that data, the U.S. Food and Drug Administration is now conducting a safety review of the potential risks of both drugs.
Many people with HIV take a combination of antiretroviral drugs, which include a protease inhibitor and a nucleoside reverse transcriptase inhibitor such as abacavir or didanosine. Concerns have been raised about the cardiovascular effects of long-term use of these drugs.
“We have investigated a number of drugs used to treat HIV patients for whether they are associated with an altered risk of having a heart attack,” said lead researcher Dr. Jens D. Lundgren, from the University of Copenhagen in Denmark. “We have identified [that] two of those drugs were indeed associated with an increased risk of a heart attack.”
The actual risk of having a heart attack when using these drugs varies with whether a patient already has underlying risk for heart attack, Lundgren added. For example, a patient who is at risk for having a heart attack will increase his or her risk by 38 percent by using either abacavir or didanosine, he said.
“However, if you have a very small underlying risk of heart attack, the risk will only be slightly increased,” Lundgren said.
In the study, Lundgren’s team collected data on 33,347 HIV patients who participated in the Data Collection on Adverse Events of Anti-HIV Drugs study (D:A:D). Specifically, the researchers looked for a connection between HIV medications and heart attack.
For commonly used drugs called nucleoside reverse transcriptase inhibitors such as zidovudine, stavudine or lamivudine, the researchers found no association with an increased risk for heart attack.
However, the nucleoside reverse transcriptase inhibitors abacavir and didanosine were associated with an increased rate of heart attack, the researchers found. For patients taking abacavir, there was a twofold increased risk for heart attack. For those taking didanosine, the increased risk was about 50 percent.
For patients who stopped using these drugs, their risk for heart attack decreased within six months, Lundgren’s group found.
In a letter published in the same journal issue, GlaxoSmithKline, the maker of abacavir, said that their own analysis of 54 studies found no increase in the risk of heart attack from the drug.
GlaxoSmithKline spokesman Dr. Didier Lapierre wrote, “We did not find a result consistent with that of D:A:D… GSK takes the D:A:D finding seriously and is committed to understanding these data more fully and to communicating openly with treating physicians and regulatory agencies globally.”
Based on the data from D:A:D, the FDA said last week that it was conducting a safety review of both drugs.
“FDA continues to evaluate the overall risks and benefits of abacavir and didanosine. This evaluation may result in the need to revise labeling for the products. Until this evaluation is complete, health-care providers should evaluate the potential risks and benefits of each HIV-1 antiretroviral drug their patients are taking, including abacavir and didanosine,” the agency said in a statement.
One expert thinks it’s more important for patients to have their HIV under control; then they can worry about potential cardiovascular side effects.
“This is a surprising and provocative finding,” said Dr. James Sosman, an associate professor of medicine at the University of Wisconsin School of Medicine. “We have not seen cardiovascular problems associated with abacavir.”
Sosman noted that the use of antiretroviral drugs has replaced concerns about serious opportunistic infections in HIV patients with concerns about less serious risks like cardiovascular disease and diabetes.
“The most important thing for HIV patient is to control their HIV,” Sosman said. “If they have excellent control with abacavir or didanosine, then you look for options to limit other risk factors. Patients not on HIV therapy have a higher risk of developing heart disease than people on HIV therapy,” he said.
The weight-loss drug Acomplia may or may not help slow atherosclerosis, a buildup of arterial plaque that’s connected with carrying too much weight.
A new trial did not find any evidence that the drug actually slowed disease progression, although it did show a decrease in one measure of plaque build-up in arteries.
Acomplia also showed a high rate of psychiatric side effects, notably depression and anxiety, the study found.
Still, Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital in New York City, who was not involved with the study, said: “I think it’s important for us to understand that this wasn’t a negative trial. It’s very important that we look at this more closely. What decrease in blood pressure and cholesterol as parameters are needed, or really how much decrease in obesity is needed for us to see a change in atherosclerosis volume? It might pan out to show something beneficial. We just don’t know.”
The study was funded by Sanofi Aventis, which makes Acomplia.
Data on a second anti-obesity drug, taranabant, also presented at the conference, also showed a high rate of psychiatric problems, although the medication did show some promise helping patients lose weight.
In the United States, two-thirds of adults are overweight, and more than one-third are obese. People with weight concentrated in their midsection have a higher risk of type 2 diabetes, high blood pressure and other risk factors for atherosclerotic cardiovascular disease or disease related to the build-up of plaque in the arteries.
Not for lack of effort, researchers have yet to happen on a “magic” treatment for obesity and its attendant problems.
One drug that has shown some promise, Acomplia (rimonabant), has been approved for use in Europe but not in the United States. Last June, the U.S. Food and Drug Administration did not recommend approval of the drug, pending more information on psychiatric side effects.
The drug works by inhibiting the cannabinoid type 1(CB1) receptors, which are involved in regulating food ingestion.
For the new study, 839 patients at 112 centers in Australia, Europe and North America were randomly selected to receive either Acomplia or a placebo. All participants, who also had coronary disease, received dietary counseling as well.
Coronary intravascular ultrasonography (IVUS) at the end of 18 months revealed a 0.25 percent increase in percent atheroma volume (PAV) in those taking rimonabant, compared to 0.51 percent in the placebo group. And change in normalized total atheroma volume (TAV) decreased in the Acomplia group but increased in the placebo group. PAV and TAV are basically two ways to measure how clogged an artery is.
Those taking Acomplia also saw other benefits: They lost more weight (9.5 pounds versus 1.1 pounds in the placebo group); their waist circumference went down more (1.77 inches versus 0.39 inches); their HDL or “good” cholesterol increased more (22.4 percent versus 6.9 percent) and triglyceride levels went down further (20.5 percent versus 6.2 percent). But LDL or “bad” cholesterol levels and blood pressure stayed about the same in both groups.
More worrisome, 43.4 percent of those in the Acomplia group experienced psychiatric problems, most notably anxiety and depression, compared to 28.4 percent in the placebo group.
