CDC identifies four drugs responsible for majority of emergency room visits (+ poll to DU)

[ZombieHorde]

A study released this week finds that four drugs are mainly responsible for most of the emergency room visits in the U.S.

The study, by researchers from the US Centers for Disease Control and Prevention, singles out four drugs and drug classes — warfarin, oral antiplatelet medications, insulins, and oral hypoglycemic agents. The study also noted that better management of antithrombotic and anti-diabetic drugs could help avoid thousands of emergency admissions.

The study, published Thursday in the New England Journal of Medicine, highlights a couple of key issues doctors and patients need to be acutely aware of. The first is adverse reactions to medication, and the second is unintentional overdoses.

According to researchers, nearly 100,000 hospitalizations every year are linked to adverse drug events such as allergic reactions and unintentional overdoses. Nearly half, or 48.1 percent, of those hospitalized were adults 80 years old or older.

Read more: http://www.thestatecolumn.com/health/cdc-identifies-four-drugs-er-visits/#ixzz1et1a8cSE

Bold is mine, so people can see the drugs at a glance.

There is also a political poll at the link, if you feel like voting.

[kickysnana]

1. Nursing home guidelines on insulin are insane.

First doctors err on the side of getting blood sugar too low and then they set a set amount of insulin no matter what and it can only be changed by a doctor.

Auntie's blood 30 min before eating was 85 and they had to give her her insulin which put her blood sugar way to low so they gave her orange juice until it came back up again which delayed her real dinner. They did this for a week before they called the doctor to change the dose and then the doctor did not want to change the dose the nurse had to argue with her. Putting someone in insulin shock four times a day is not a good thing at all.

[eomer]

2. Pardaxa is a new drug that purportedly eliminates the major problems with taking warfarin (Coumadin)

With warfarin/Coumadin the dosage has to be carefully calibrated for each individual. It is difficult to find and maintain the right level and the patient therefore has to be tested frequently and the dosage adjusted.

With Pardaxa everyone takes the same dose, which eliminates the difficulties in taking it and the risk of getting the dosage too high or to low.

My Mom has taken Coumadin for a number of years (valve replacement) and has more than once been sent to the emergency room when a test result came out too high or too low (don't remember which). It is a very frustrating drug to have to take for the rest of your life because it entails a constant problem that the dosage always seems to be too high or too low.

Pardaxa is apparently more expensive than Coumadin (or generic warfarin). My FIL has just been diagnosed with Atrial Fibrillation and the cardiologist wants him on either Coumadin or Pardaxa. So far he is choosing Coumadin because of the cost.

All the above is from personal experiences and a couple of web searches so obviously you will want to do your own research.

[elias7]

4. It does but very $$$$$ expensive.

Problem is, when docs rx it, people complain about big pharma and profits without really appreciating the hours and dollars by researchers put into this and other drugs.

[ret5hd]

5. how much of the hours and research was paid for by our govt?

and which is greater:
research dollars
advertising dollars

i don't know the answers to these questions for this specific drug, but the answers for the drug industry as a whole are widely known.

on edit: because i don't like to leave things unsubstantiated:
http://www.sciencedaily.com/releases/2008/01/080105140107.htm

<snip>
A new study by two York University researchers estimates the U.S. pharmaceutical industry spends almost twice as much on promotion as it does on research and development, contrary to the industry’s claim.
</snip>

[Yo_Mama]

3. Interesting topic, thanks for posting it

Given the types of drugs involved, it may be difficult to lower ER visits. The anti-clotting drugs are acutely necessary, and while blood sugar lowering drugs always entail some danger, it is monumentally less than not treating diabetes.

More monitoring might help, but we have to remember that too many diabetics, for example, struggle to afford testing equipment as it is. Nursing care would help, especially for the elderly, but we are cutting funds available to Medicare and this is surely going to make the situation worse!