Doctor’s Blog

April 29, 2010

Need Help in Paying for Drugs?

With the economy in the state it is, many patients are having a difficult time paying for expensive drugs. The pharmaceutical industry has long provided free or low-cost medicines provided that strict financial requirements are met. Many companies have different rules, so it is not a “one size fits all.”

Applications are available from the drug companies themselves or by going to these websites that are patient-advocate groups. These sites generally guide patients in filling out the information.
 
Most patient-assistance programs require enrollees to have incomes at or below 200% of the federal poverty level, or about $42,000 for a family of four, but some allow as much as 400%.
 
Patient-assistance programs
Discount drug cards
Obtaining low-cost generic
www.needymeds.org. Patients can search and download applications etc.
www.togetherrxaccess.com or1-800-444-4106 Nine major drug companies free card:20%-40% for more than 300 drugs.
www.rxoutreach.com or1-800-769-3880. Offers more than 350 generic meds at $20-$95 for 180 day supplies.
www.pparx.org or 1-888-477-2669. Helps to match patients with more than 475 programs.
Discounts range from 15%-50%
www.xubex.com or 1-800-699-8239. Over 250 generic drugs 90 day supply most for $20-$30
www.rxassist.org. Allows patients to search online for tip sheets on getting low-cost meds and other information.
Discounts range from 15%-50%
Wal-Mart, Target, Safeway and other chains at $4. Several have reduced costs of generic drugs to $10-$15.


 

April 14, 2010

Could Higher Vitamin D Levels Improve Asthma Symptoms?

 
A recent study in the American Journal of Respiratory and Critical Care Medicine examined vitamin D blood levels in adult asthma patients, and showed that those with the highest levels of vitamin D had better lung function. Low vitamin D levels were associated with a worse response to steroid therapy and increased production of TNF-alpha, an inflammatory substance secreted by cells.
 
The authors also found that participants who weighed the most had the lowest levels of vitamin D, suggesting that the lack of vitamin D may be a factor linking obesity and asthma. The lead investigator of the study, Rand Sutherland, MD, MPH, was quoted on WebMD as saying, “The next question to answer is whether giving supplemental vitamin D will lead to clinical improvements in patients with asthma.”
 
Further studies to address the potential benefits of increasing vitamin D supplements for asthma patients are needed. For now, it is recommended that you get the current daily recommended dosage of vitamin D based on age.
 
Infants 0–12 months
200 IU
Children 1–18 years
200 IU
Adults 19–50 years
200 IU
Adults 51–70 years
400 IU
Adults 71 years and older
600 IU
Pregnant and lactating women
200 IU
 
For infants, children, and adolescents, the American Academy of Pediatrics advises daily intakes of 400 IU, twice the official recommendation of 200 IU.
 
Vitamin D is found in many dietary sources, such as fish, eggs, fortified milk and cod liver oil. The sun also contributes significantly to the daily production of vitamin D, and according to the Mayo Clinic, as little as 10 minutes of exposure is thought to be enough to prevent deficiencies. Vitamin D toxicity can occur with overdosing, so patients should be careful not to take excessive amounts. 
April 8, 2010

H1N1 Update

Visits to doctors for influenza-like illness are now stable and relatively low nationally. However, the majority of the influenza viruses identified so far continue to be 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine and remain susceptible to the antiviral drugs oseltamivir and zanamivir, with rare exception. It is still recommended that persons get vaccinated with the H1N1 vaccine, if they have not already done so, should another wave of flu activity occur.

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April 1, 2010

What does a black box warning mean?

The FDA places a “black box” warning on the package insert of prescription drugs that might cause serious adverse effects. Recently, long-acting bronchodilators such as Foradil (formoterol) and Serevent (salmeterol) have appeared on this list. The FDA is concerned about the safety of these drugs when used alone.

 
These medications, also called LABAs, are powerful bronchodilators that last approximately 12 hours. Most often, LABAs are combined with inhaled corticosteroid drugs (ICS). LABAs relax the bronchial smooth muscles, but do not address the inflammation of the airways. Inhaled corticosteroids act by reducing this inflammation.
 
The reason for the concern is that children and adults (especially African Americans) may be subject to increased and severe asthma attacks when given LABAs alone. This can lead to hospitalization and even death.
 
However, this situation has been noted for patients on LABAs alone and does not apply if the combination is given. Nevertheless, the FDA cautions that patients should avoid the combination when possible, and LABAs should never be given alone to treat asthma symptoms on a regular basis.
 
Our note: We agree with this approach. We try to give the least amount of medicine that we can to relieve not only symptoms, but also the core of the asthma problem — inflammation.

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