Ethics in Medicine

Drugs causing the problems they're supposed to prevent

Kristen Sparrow • October 17, 2010

From the NYTimes:

“In the past month, the Food and Drug Administration has concluded that in some cases two types of drugs that were supposed to be preventing serious medical problems were, in fact, causing them.
One is bisphosphonates, which is widely used to prevent the fractures, especially of the hip and spine, that are common in people with osteoporosis. Those drugs, like Fosamax, Actonel and Boniva, will now have to carry labels saying they can lead to rare fractures of the thigh bone, a surprising new discovery that came after another surprise — that they can cause a rare degeneration of the jawbone.
The other is Avandia, which is widely prescribed for diabetics, whose disease puts them at risk for heart attacks and heart failure. Two-thirds of diabetics die of heart problems, and a main reason for taking drugs like Avandia is to protect them from that…”

They then go on to quote experts who feel that the FDA doesn’t do enough to track drugs after they’ve been turned loose on the (unsuspecting) public. Since drugs only undergo a relatively short testing period, it would, of course make sense to continue tracking drugs once on the market. Where that money will come from I have no idea in this political climate, especially since the FDA has shown to be infiltrated with people from the drug industry with a vested interest. (See blog post “When oversight means overlook”)
Given the shortcomings, and lack of oversight in the FDA I think it makes utmost sense as a health care consumer to wait at least 7 years before taking any newly released drug. Let others be the guinea pigs and if possible, take the version of any medication that is tried and true if given a choice. It’s often cheaper, too.
I like to think that attitudes are changing among physicians, and that they’re less willing to prescribe newly minted drugs, but I’m not sure if there is any evidence for that. I understand the drug companies rushing drugs to market, after all there is a boat load of money to be made. But I’m not sure I understand the eagerness of physicians to enable them. It could be pressure from patients themselves, who knows. But they should remind themselves of their oath to “first do no harm” and consider counseling weight bearing exercise and dietary changes before bisphonphonates and Avandia.

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