Medication Archives - MyMedicPlus

Study suggests dolutegravir is the optimal first-line HIV medication

mymedicplus — Tue, 20 Oct 2020 06:06:38 +0000

Source – https://www.europeanpharmaceuticalreview.com/

Researchers comparing dolutegravir to efavirenz suggest dolutegravir increases viral suppression and has similar rates of adverse events.

A new study has found that dolutegravir is the optimal medication for first-line treatment for people newly diagnosed with HIV. This discovery could change international treatment recommendations for newly diagnosed HIV patients, an update that could affect nearly two million people per year worldwide.

The study published in EClinicalMedicine was commissioned by the World Health Organization (WHO) as part of a planned update to its guidelines for HIV antiretroviral treatment (ART).

“Research supporting the 2016 WHO guidelines suggested that dolutegravir was effective and well tolerated, but its efficacy and safety among key populations, such as pregnant women and people living with both HIV and tuberculosis (TB), remained unclear,” said the study’s lead author, Dr Steve Kanters, who completed the research as a PhD candidate in University of British Columbia’s School of Population and Public Health (SPPH). “In 2018, new research warned of a potentially serious increase in risk of neural tube defects in the children of women who became pregnant while taking this treatment.”

According to the researchers, this risk meant that despite its favourable profile compared to other drugs, dolutegravir was only recommended as an alternative, with the antiretroviral efavirenz recommended as the primary treatment.

The study team completed a network meta-analysis of research stemming from 68 available antiretroviral therapy (ART) clinical trials. They found dolutegravir was superior to efavirenz in most outcomes, including viral suppression, tolerability and safety. Kanters commented that the five percent increase in the probability of viral suppression with dolutegravir could have a significant impact on achieving international goals for HIV treatment.

According to the researchers, another key attribute of dolutegravir is that it is effective in people who are resistant to NNRTI-class antiretrovirals (including efavirenz), a problem that is becoming increasingly common.

The analysis also showed that dolutegravir and efavirenz had similar rates of adverse events for pregnant women. The report stated that the increased risk of neural tube defects for dolutegravir was estimated to be less than 0.3 percent, which Kanters said shows “that the risk with dolutegravir is much more tolerable than previously thought and should quell the initial worry about this drug”.

“Dolutegravir appears to be here to stay as the preferred treatment for people newly diagnosed with HIV. However, it is important to recognise the good that efavirenz has done over the past two decades, as it helped lead the ART scale-up around the world,” added Kanters.

While this study is specifically focused on the optimal treatment for people newly diagnosed with HIV, an upcoming publication will review the evidence in support of switching to dolutegravir for people whose first treatment choice has been unsuccessful in controlling their HIV infection. This recommendation could mean improved treatment for the many people living with HIV around the world who are unable to achieve viral suppression despite being on treatment.

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Medication Timing and Blood Pressure

mymedicplus — Mon, 09 Mar 2020 07:03:16 +0000

Source:myprimetimenews.com

Last month we considered medication timing. Sometimes it is best to take medications when you can best remember them, sometimes when they can best help your symptoms, and sometimes based on scientific data.

The Hygeia Chronotherapy Trial is an example of a scientific study that supports taking medication at a specific time. In the Hygeia Trial, patients took all their hypertension medicine either in the morning or at bedtime. About 19,000 patients participated over a ten year period to help determine if patients would be better off taking their medications in the morning or at night.

Patients with high blood pressure are at increased risk for various forms of heart disease, including heart attack, vascular disease, heart failure and stroke. The study looked at the incidence of cardiovascular events as well as their outcome.

One of the things that made the study so interesting was that going into the study, you could argue either way. Patients tend to remember to take medicines more regularly when they take their medicines in the mornings. When measured, hypertension medicines stay in the body for more than 24 hours, so it shouldn’t matter when you take them as long as it’s about once a day. On the other hand, blood levels of drug are highest shortly after taking them, and many cardiac events occur in the early morning hours, so it might be better to take blood pressure medications at night. It really would have been interesting if pharmacologists and physicians could have wagered on the results.

When the study concluded after more than 10 years, the results were striking. Patients taking their blood pressure medications at night fared better than those taking the same medications in the morning. Patients taking blood pressure medications at night had slightly lower blood pressure readings throughout the day and at night. Surprisingly, those taking blood pressure meds at night also had slightly better cholesterol readings. While the results differed statistically, they appeared small and it was hard to see how they could have any profound affects long term.

We have to recognize that scientists and the media can benefit from making results sound more important than they are. One of the ways that pharmacists and other medical professionals will evaluate results like the Hygeia Trial is by how many patients will need to change their medication schedule to cause one person to be affected. For the Hygeia Trial, the results indicate that over the first two years, one cardiovascular event – a heart attack, stroke, angina, peripheral artery disease or transient ischemic attack – is avoided for every 20 patients taking their blood pressure medications at night instead of in the morning.

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4 simple tricks for fighting insomnia without medication

mymedicplus — Thu, 05 Mar 2020 05:51:26 +0000

Source:theladders.com

Roughly three million Americans develop insomnia each year. Just about 30% of this demographic experience persistent symptoms as a direct result of the condition and roughly 10% exhibit symptoms debilitating enough to disrupt their daily functions.

According to the American Academy of Sleep Medicine, the most common symptoms of insomnia include fatigue, moodiness, irritability, anger, hypersomnolence, lack of concentration, poor memory, and headaches.

More often than not poor sleep is authored by psychological factors, with anxiety being chief among them. Clinical care might certainly help attenuate these scenarios but developing sustainable life habits optimizes every conceivable measure.

In the past, Ladders has focused on the dietary elements of non-pharmaceutical sleep care but there’s a lot to be said for the effectiveness of physical practices.

Larry Piller, Certified Massage Practitioner and author of Stretching Your Way: A Unique & Leisurely Muscle Stretching System, recently imparted Ladders with several physical remedies for “bleary-eyed people” suffering from chronic insomnia.

“Stretching has many benefits, and one of those is that it can help you wind down and ease the tension at the end of the day,” Piller explained.

Below are four-techniques shown to promote quality sleep without the need for medication or a dramatic lifestyle change:

“Just by knowing that these stretches are waiting for you anytime you want them, day or night, it will give you a feeling of tranquility as opposed to a night of anxiousness. It’s like having your favorite ice cream waiting in the freezer, Piller continued.

Stretch 1. While lying on your back, extend your right shoulder and elbow out to the side as far as is comfortable. At the same time, bring your thumb and hand downward. “You can also perform this stretch while standing, Piller says.

Stretch 2. As you lie on your back, bring your toes downward and the sides of your foot inward. These stretches for the tops and sides of your feet can be done lying on your side as well, as long as you have room to bring your foot or feet down or inward. You also can use a pillow between your legs to raise your foot so you can bring your foot or feet down, or hang your feet over the edge. “This by itself, or in combination with other stretches, has a high chance to put you to sleep like a little baby,” Piller adds.

Stretch 3. Lying on your back, stretch both arms out. Make a light fist or let your hand dangle over the edge of the bed, extending your shoulder and arms out as much as is comfortable. “For any stretch with your arm over the edge of the bed, if you would rather, you can prop it up with a pillow. In any position that feels good, put your arm over the pillow and let its leverage pamper you.”

Stretch 4. While lying on your back, just extend your shoulder and arm out as is comfortable

Insomnia may be ubiquitous but it’s also one of the most treatable impairments in the world.

According to a recent study conducted by the Pennsylvania School of Medicine, 75% of insomnia sufferers recover from their condition without medical intervention. If the underlying cause is one related to psychosis seek medical attention, though yoga and medication have been studied to optimize the effect of psychiatric treatment.

“Whether caused by stress, illness, medications, or other factors, poor sleep is very common,” said senior author Michael Perlis, PhD, an associate professor of Psychiatry and director of the Behavioral Sleep Medicine program. “These findings reveal new insights about the paths that acute insomnia takes and can inform interventions that target poor sleep and help people recover sustained sufficient sleep.”

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People with Damaged Livers Can Continue Medication for Diabetes

mymedicplus — Mon, 02 Mar 2020 08:03:28 +0000

Source: newsgram.com

People with diabetes, hypertension and depression might be able to continue taking life saving medications in small doses even while they heal from drug-induced liver injuries, suggests new research.

The findings, published in the journal Drug Metabolism and Disposition, suggests that doctors need not always make patients with drug-induced liver injury stop taking all their medications until the liver healed.

Drug-induced liver injury — when a person accidentally harms their liver by taking medications prescribed by a doctor (or occasionally over the counter drugs) — affects about almost 1 million people globally. “Doctors give patients drugs to treat diseases. No one wants their liver damaged, but it happens all the time,” said Xiaobo Zhong from the University of Connecticut in the US.

When a person takes a medication by mouth, it goes into their stomach and then to the intestines, where it is absorbed into the blood. This blood, in turn, passes first through the liver before reaching the rest of the body. The liver has enzymes that break down medicines.

But different people naturally have more or less of these enzymes. Sometimes, what could be a safe and effective dose in one person is too much for someone else who has different enzyme levels. This is why some individuals are more vulnerable to liver damage, even when taking drugs just as a doctor prescribed.

There is no standard guidance for doctors when a patient gets drug-induced liver damage. Often times they tell the person to stop taking all medications immediately and wait for their liver to recover. But that can take weeks or months.

“But if patients have chronic conditions such as diabetes, hypertension, or depression, their conditions can run out of control,” if they stop taking the medications, Zhong said. And that can be life threatening.

The researchers tested whether mice whose livers had been damaged by acetaminophen (the active ingredient in Tylenol) had lower levels of drug metabolising enzymes, called cytochrome P450 enzymes.

The researchers investigated whether mice with drug-induced liver damage can safely take medications for diabetes, hypertension and depression. It looks like they can, as long as the doses are much smaller than normal, said the study.

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Top diet and nutrition news of 2019: Hydrogel pill, fasting, keto diet medication changes

mymedicplus — Mon, 23 Dec 2019 06:14:02 +0000

Source: healio.com

Low-carb, ketogenic, Mediterranean, time-restricted, alternate-day fasting — Healio readers were interested in the effects of different eating plans on weight loss and cardiometabolic measures. Also, different exercise programs may benefit different people, but it’s never too late to start.

Exercise and cardiometabolic health: ‘Never too late to start exercising’

Exercise provides important and varied benefits for individuals with cardiometabolic disorders regardless of experience level, and certain exercise types may yield better outcomes for those with certain conditions.

FDA approves hydrogel pill for overweight, obesity

The oral capsule, (Plenity, Gelesis100), a first-in-class hydrogel matrix containing cellulose and citric acid, is the first obesity treatment the FDA has approved for adults with a BMI as low as 25 kg/m², with or without comorbidities.

Multiple type 2 diabetes benefits achievable through low-carb diets

Adults with type 2 diabetes can experience multiple diabetes-specific benefits beyond weight loss by undertaking a low-carbohydrate diet, although potential risks must be addressed.

Consistent, 10-hour daily eating window benefits adults with metabolic syndrome

Adults with metabolic syndrome, even those prescribed antihypertensive and statin drugs, who consistently limited food and beverage consumption to the same daily 10-hour period for 12 weeks experienced improvements in body composition, blood pressure and cholesterol levels.

Alternate-day fasting cuts insulin levels, resistance in half

Eating only every other day lowered levels of fasting insulin and insulin resistance to a greater degree than calorie restriction among adults with overweight or obesity and insulin resistance.

Despite similar weight loss, low-carbohydrate diet delivers insulin reductions, smaller fat cells than low-fat diet

Eating plans low in carbohydrates result in smaller fat cells vs. low-fat/higher-carbohydrate plans after similar weight loss, which may yield better metabolic health.

Ketogenic, low-carb diets require diabetes medication adjustments

Consider these medication revisions for adults with diabetes who adopt a ketogenic or other low-carb eating plan that can affect glucose levels and blood pressure.

Mediterranean diet with behavioral support improves meal plan adherence, CV risk factors

Adults with metabolic syndrome assigned to a reduced-calorie Mediterranean diet plan with physical activity and behavioral support were more likely to stick with the program, report better diet quality and reduce their cardiovascular risk factors.

Replace diet discussions with focus on mindful eating

Balanced eating plus consistent carbs is a challenging message to communicate during a brief office visit. Shifting the conversation away from restrictive diets toward mindful eating helps move the relationship with food from adversarial to nourishing.

Glycemic benefit more robust with less-processed whole-grain breads

Adults with type 2 diabetes may derive superior glycemic benefits from eating breads with larger vs. smaller whole-grain particles.

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Food therapy to check overweight, obesity

mymedicplus — Tue, 25 Jun 2019 09:21:13 +0000

Source: thehindu.com

The district health authorities have brought out a special patient book with a menu card for preventing overweight and obesity.

The initiative is a part of a campaign against non-communicable diseases (NCDs). The programme, first of its kind in the State, is in the process of getting implemented in all NCD clinics in the district.

According to Dr. K.R. Vidya, deputy district medical officer who is heading the NCD cell, the preventive action consists of food therapy and exercises, and there is no medication. “It is for those who volunteer for the therapy,” she said. However, those who are diagnosed with diabetes and hypertension are provided medication.

Those identified as overweight and obese are referred to the NCD clinics for the therapy. A registration book and a patient book are maintained for those coming in. The patient book contains menu cards with different combination of foods to be taken every day.

“We have set the menu card for 1,500 kilo calories as the daily intake,” said Dr. Vidya.

Patients who come for the therapy need to follow the menu that is set for Monday to Sunday. Jotting down on the foods in the book will help follow the extra intake each day. People who register for the therapy have to consult the doctor after a week’s programme and then regularly every month.

After the initiation into the food therapy, exercises would also be suggested for weight loss.

The district has added 43,491 new diabetes patients in 2018-19 to the already registered 3.49 lakh patients on a follow-up programme. The year also saw an addition of 23,445 new hypertension patients to the existing 3.23 lakh patients.

This year, 4,426 patients having both diabetes and hypertension were added to the existing 2.35 lakh patients.

While females were more in numbers for diabetes, hypertension and a combination for both, more males were detected with cardiovascular diseases and stroke.

As part of preventive activities, 76,570 people, which included 34,415 males, were given counselling against tobacco use, while 1,75,337 were counselled for preventive NCD and health.

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High blood pressure is the silent killer

mymedicplus — Mon, 24 Jun 2019 13:14:12 +0000

Source: tylerpaper.com

Community health care leaders met in May to discuss high blood pressure in our community, and how we have a lot of people experiencing complications from untreated or undertreated high blood pressure. We have excellent hospitals, clinic systems and primary care physicians in our community. We have an engaged public health department and multiple clinic locations for uninsured members. We have a fully accredited heart hospital and excellent cardiologists. We have many primary care clinics who have received patient-centered medical home certification and have processes in place to screen for and treat high blood pressure. So why do we still have a lot of people in our community with undertreated high blood pressure?

Some people simply have not been screened. High blood pressure often offers no symptoms, and patients do not know how their blood pressure is doing simply based on the way they feel. Sometimes people will only go to the doctor when they are sick, and often they assume that their elevated blood pressure was because they did not feel good and are not due to true blood pressure problems. This is a dangerous assumption, and reduces our ability to intervene.

Many pharmacies provide free use of blood pressure machines that are fairly accurate. Ideally, the person would sit at the blood pressure station for 5 minutes to be sure their resting heart rate and blood pressure goes back to its normal value, especially if they walked a lot around the store. If their blood pressure is high after sitting for three to five minutes and the person is not sick or in pain, chances are they truly do have high blood pressure that is not being treated as well as it should be.

Other challenges we have in our area are a high smoking rate and a diet that is high in fat and salt. We also have high obesity rates. All three of these things — smoking, diet and obesity — are risk factors for high blood pressure. Ideal treatment of high blood pressure would not just involve the use of medications, but would also encourage healthy eating behaviors and exercise.

It is important for patients to be informed about what untreated and undertreated high blood pressure can do. This can lead to strokes, heart failure, heart attacks, kidney failure, poor leg circulation, sexual side effects in men and other long-term problems. Common causes of death from long-term, undertreated high blood pressure are heart attacks and strokes. The tricky thing is that these complications do not always occur right away, and patients feel a reduced sense of urgency to treat their blood pressure problems. Sometimes the heart attack or the stroke was caused by years of missed opportunities to treat the high blood pressure when it could have made a difference.

There are many blood pressure medications on the $4 medication discount list at several local pharmacies. Treatment of high blood pressure is often inexpensive, yet many patients simply do not know where to go nor understand why it is important to take their medication. Even though we have many clinics that will see patients at reduced or no cost if they are uninsured, patients do not know that these clinics exist or understand how to access them.

While blood pressure targets are adjusted based upon a person’s risk factors, a good rule of thumb is that normal blood pressure is 120/80, and most doctors agree treatment is needed if the blood pressure stays over 140/90. What is your blood pressure? If you do not know your blood pressure, then please get screened ASAP, either at a local clinic or using a blood pressure machine at a local pharmacy. If your blood pressure is high and you do not know how to access locations for care, please call the Center for Healthy Living at 903-593-7474, or visit it from 8 to 11:30 a.m., and from 1:30 to 4:30 p.m. Monday through Friday. You can receive a free blood pressure reading and get connected to other local health resources that will help you control your high blood pressure.

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