No “right” answers

When it comes to prescribing drugs, doctors must weigh the risk of giving any drug versus the benefits of those drugs.  Common drugs that we use today have significant and at times fatal reactions. 

Guess the drugs that correspond to the following side effects:

Side effects: Anaphylactic shock and death. Drug: Penicillin. 

Side effects: fatal bleeding, anaphylactic shock and asthma with severe respiratory distress.  Drug: Aspirin.

Side effect: respiratory depression with cessation of breathing. Drug: morphine. 

I could go on and on.

This is the practice of medicine.  You have a disease and need a treatment.  Doctors try and find a treatment which is not worse than the disease.  The drugs reported on in this study were being used in the disease of congestive heart failure.  Congestive heart failure, when it is Class 3 or 4, has almost 100% mortality at five years.  This class of drugs when used in this disease state significantly increases your chance of living and improving your quality of life.  Is it worth it to take the drug?

It is true that the same benefit is received when you take angiotensin converting inhibitors but many patients have side effects from those drugs.  The angiotensin converting enzyme blockers are better tolerated.  They are also much more expensive and many patients are given angiotensin converting enzyme inhibitors first and then when they are not tolerated switched over.

What this study really does is to provide a starting point for further evaluation.  There is a wealth of data that the FDA has and these studies are meant to serve as a means of impelling them to review their data or providing it to people who will.

In the next weeks the public will hear about the diabetic drug Avandia which has been in the news over the past year.  It is very possible that this drug which already carries a “black box” warning, which is the highest level of warning the FDA has, maybe removed from the market.  We will have to wait and see.

In the meantime, if you are taking these drugs continue them and discuss this with your doctor.  If you really don’t want to get lung cancer don’t smoke.  In London, the cigarette packages say smoking kills in large print.  Better than our warnings.

Tags: angiotensin converting inhibitors, Avandia, congestive heart failure, Drugs

This entry was posted on Friday, June 25th, 2010 at 11:25 pm and is filed under Heart Failure, diabetes. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.