ADHD drugs perform better than assumed

Attention deficit hyperactivity disorder (ADHD) affects an average 9 percent of U.S. children between ages 5 and 17, making it one of the most common childhood disorders. Because children affected by ADHD experience problems staying focused, hyperactivity, and disruptive/aggressive behavior, they are likely to fall behind at school and display risky behavior as teenagers. While such drugs as methylphenidate (Ritalin) may help children with ADHD concentrate better and control impulsivity, some argue that the prescription stimulants transform children into "robots" or "drug them into acquiescence." However, the latest research on the matter reveals that the ADHD children themselves do not agree. Many say that they still are the same people but they "just act a little better."

Osteoporosis drugs help men, too

While the bone-thinning disease known as osteoporosis is often thought to be a woman's health problem, it also poses a significant fracture risk for men. Women's lifetime risk of suffering an osteoporotic fracture is about 50 percent; for men, the risk is estimated to be about 25 percent. Fortunately, men can avail themselves of the same class of drugs (bisphosphonates) that women use to prevent the loss of bone mass and derive equal benefit. According to recent research, use of the drug zoledronic acid (Reclast) helped men with osteoporosis significantly reduce their risk of fractures of the spine. The first step toward realizing this benefit requires men to have their bone density tested and evaluated.

Medication cautions for pregnancy-minded women

If you are pregnant or thinking about conceiving, you should know that there are risks associated with taking prescription painkillers. Various factors that influence the risk of birth defects include how much medication a woman takes, at what stage of her pregnancy she takes it and what health conditions she might have. With this in mind, women thinking about getting pregnant should discuss the fact with their prescribing physicians. Taking such prescription opioid painkillers as codeine, hydrocodone or oxycodone (Oxycontin) may increase the risk of birth defects in children of women taking these drugs. Taking these drugs just prior to pregnancy or during pregnancy is linked to a moderate risk of congenital heart defects among newborns.

Potential Z-Pak concern

Azithromycin, which is often sold in a five-day dose known as a Z-Pak, is an antibiotic commonly used to kill bacteria that cause middle-ear infections, strep throat, sinusitis and pneumonia. It is therefore newsworthy that a recent study linked azithromycin with an increased risk of irregular heart rhythms in some patients. Azithromycin is part of the macrolide class of antibiotics, which includes erythromycin and other antibiotics that pose similar risks for those with heart disease risk factors. At the same time, the study found no similar risks associated with other antibiotics that treat many conditions as well as azithromycin, most notably, amoxicillin and ciprofloxacin. It may make sense to discuss these alternatives to azithromycin if you have a heart condition.

Taking medications via microchip

If you aren't a fan of needle injections, you may be interested to learn that drugs may now be delivered by microchip. This new way of delivering medication has already been tested among osteoporosis patients. It involves the use of an implanted microchip that has a wireless receiver, which signals the microchip to release the drug. This method of drug delivery is different from most current drug-delivery systems that slowly release small amounts of the drug. Instead, the microchip releases all the medication at once, much like a needle injection. While there are still some issues to work out, the system holds great future promise for delivering medication to patients who have trouble taking their medications regularly.

Migraine prevention

Medications that prevent migraines from recurring are only used by a small number of the roughly 15 percent of the adult population affected by the painful headaches. According to the American Academy of Neurology (AAN) and the American Headache Society (AHS), nearly 40 percent of migraine sufferers could benefit from preventive drugs, but less than a third of these individuals take them. New guidelines put forth by the AAN and AHS list several drugs that help stop migraines before they start. These include the anti-seizure drugs divalproex (Depakote), valproate (Depacon) and topiramate (Topamax), in addition to the beta-blockers metoprolol, propranolol and timolol. While all of these drugs have side effects, their benefit must be weighed against any potential downside.

Feeling feverish?

We have all been educated to think that 98.6 degrees Fahrenheit is the average body temperature of humans and that anything above that reading indicates a fever. However, it's not really that simple. Rectal temperature, which most accurately reflects true internal body temperature, varies from 97.9 degrees F. (morning) to 100.4 degree F. (late afternoon). Oral, armpit and ear temperatures, which are less accurate and can be influenced by external factors, can be as low as 94.5 degrees F. To determine your personal "normal" temperature, take three readings (morning, noon and night) at any one of the four sites, and calculate your average temperature for each of the three times of day. Use those numbers as your base temperature.

Does grapefruit juice stymie statin drugs?

If you are prescribed cholesterol-lowering drugs, you should know that some may be vulnerable to an adverse interaction with grapefruit juice. While "statins" such as rosuvastatin (Crestor), fluvastatin (Lescol) and pravastatin (Pravachol) do not interact with grapefruit products, atorvastatin (Lipitor), lovastatin (Mevacor, Altoprev) and simvastatin (Zocor) are susceptible to harm from grapefruit juice.

What to take for arthritic knees

Osteoarthritis of the knees is a common problem, particularly after age 60. While low-impact aerobic exercise, muscle strengthening, and stretching can help increase range of motion and decrease pain, medications are often also necessary. If so, the American Academy of Orthopedic Surgeons recommends the following medications to control symptoms: no more than 4 grams of acetaminophen (Tylenol) per day; non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen sodium (Aleve) taken with food; cyclooxygenase-2 (COX-2) inhibitors, such as celecoxib (Celebrex); or topical NSAID diclofenac sodium (Voltaren Gel). These recommendations are designed to reduce the risk of gastrointestinal bleeding. If they cannot be tolerated or greater pain relief is needed, a corticosteroid injection may be needed.

Travel advice

Whether you are going to drive or fly, if you plan to travel with medications, it is best to keep them in the passenger compartment, not the vehicle's trunk or the jet's storage area. According to the U.S. Pharmacopeia, most medications should be kept at temperatures between 68 and 77 degrees Fahrenheit in order to maintain optimal quality and effectiveness. Practically speaking, a wider temperature range between 59 and 86 degrees is also acceptable, but excessive heat should be avoided. It is also prudent to check drug labels for warnings about proper storage. Drugs such as insulin require refrigeration. If there are any questions, ask the pharmacist about any special precautions that should be taken with medications while traveling.

Migraine medication may increase birth-defect risk

Cleft lips and palates occur when the mouth does not fully form, which leads to a split lip or hole in the upper palate. While such oral birth defects are relatively rare in the United States, it has been found that an epilepsy drug used to help prevent migraines can increase the risk of these defects in babies born to mothers who take the medication. According to the FDA, expectant mothers who take the drug topiramate (Topamax) are about 20 times more likely to have infants with cleft lips or cleft palates than women not taking the medication. Women of childbearing age should know that the defects occur during the first three months of pregnancy, often before a woman knows she is pregnant.

Treating sinus inflammation

When sinus inflammation (sinusitis) strikes, most people probably think that the best thing to do is get a prescription for antibiotics from their doctors. However, antibiotics are ineffective in 90 percent to 98 percent of all sinusitis case because nearly all sinus infections are viral in nature, and antibiotics don't kill viruses. Currently, one in every five antibiotic prescriptions written for U.S. adults is written for sinusitis. Keeping in mind that unnecessary and unneeded antibiotic use leads to more virulent strains of antibiotic-resistant bacteria. The Infectious Diseases Society of America recommends that doctors only suspect a bacterial infection when sinusitis symptoms last ten days or more and do not improve. After that, a five to seven day course of amoxicillin is often recommended.

Expanded use of prostrate cancer drug

The FDA recently approved the expanded use of a drug that was initially approved to treat prostate cancer patients whose disease had progressed after treatment with the chemotherapy drug docetaxel. Now, Zytiga can also be used to treat men with late-stage, hormone therapy-resistant prostate cancer before they undergo chemotherapy. Zytiga works by decreasing production of the male sex hormone testosterone, which stimulates the growth of prostate tumors. The approval of this expanded use of Zytiga was made under the FDA's priority review program, which provides an accelerated six-month review for medications that may present major advances in treatment or provide a treatment when adequate therapy is not available for the treatment of disease.

Is newer necessarily better?

Pharmacists can perform an important service to consumers by informing them about drug effectiveness. For instance, when an older drug is just as effective as a newer one and costs substantially less, the pharmacist may disabuse a patient of the widely held notion that something newer is necessarily better. Similarly, the pharmacist may help dispel the notion that, if something costs more, it is necessarily better. As a case in point, three of the oldest and least costly medications used to treat type 2 diabetes (metformin, glimepiride and glipizide), when taken alone or in combination, may be better first choices for diabetics than newer brand-name drugs like pioglitazone (Actos), rosiglitazone (Avandia) and sitagliptin (Januvia). It may pay to ask.

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