Greenspoint Pharmacy

11/16/2021

Roger Seheult, MD of MedCram explains new data on COVID 19 vaccines vs mortality rates (both coronavirus related and non COVID-19 related deaths). COVID-19 ...

08/31/2021

Just for your information.

Professor Roger Seheult, MD explains the important role Vitamin D may have in the prevention and treatment of COVID-19. Dr. Seheult is the lead professor at...

07/22/2019

Thanks.

12/17/2018

By Joe Dangor

Oxybutynin lessens hot flash frequency, improves breast cancer survivor quality of life, Mayo-led study finds
December 7, 2018

SAN ANTONIO — Research led by oncologists Roberto Leon-Ferre, M.D. and Charles Loprinzi, M.D. of Mayo Clinic has found that the drug oxybutynin helps to reduce the frequency and intensity of hot flashes in women who are unable to take hormone replacement therapy, including breast cancer survivors. These findings were presented at the 2018 San Antonio Breast Cancer Symposium.
“Hot flashes are a common symptom of menopause and can be even more severe in breast cancer survivors than they are in the general population,” says Dr. Leon-Ferre. He says several factors contribute to the increased severity of hot flashes in breast cancer survivors including exposure to chemotherapy, which may bring on early menopause; the use of antiestrogen drugs, such as tamoxifen or aromatase inhibitors; and the use of medications or procedures to suppress the function of the ovaries. Hormone replacement therapy, which is sometimes used to treat hot flashes, is generally not recommended for breast cancer survivors. “Hot flashes not only impact a patient’s quality of life, they are associated with patients prematurely discontinuing breast cancer treatment, which may increase the risk of breast cancer recurrence and mortality,” says Dr. Leon-Ferre. “It is important for physicians to have effective options to treat hot flashes.”
Dr. Leon-Ferre says previous research had suggested that hot flashes may be relieved with oxybutynin, an anticholinergic agent which interferes with the activity of a neurotransmitter in the brain and in the peripheral nervous system. The drug is most commonly used to treat urinary incontinence. Dr. Leon-Ferre said that since oxybutynin is already available for other indications, physicians could potentially prescribe it off-label. However, he says the study did not address long-term toxicities of oxybutynin. Previous research has indicated that long-term use of this type of drug may be associated with cognitive decline. These possible side effects should be further researched and taken into consideration when physicians counsel patients.
In this study, researchers sought to determine whether oxybutynin was more effective than placebo in treating hot flashes and in improving patients’ quality of life. The researchers enrolled 150 women who had experienced at least 28 hot flashes per week over more than a month, and who were bothered enough by them to want medication. Sixty-two percent of the women were on tamoxifen or an aromatase inhibitor for the duration of the study. There were three arms in the trial with patients in two arms receiving different dosages of oxybutynin and patients in the third arm receiving a placebo.
The study found that patients on both oxybutynin doses saw decreases in hot flashes compared to the women who took the placebo. The women in both oxybutynin arms also reported decreased interference of hot flashes in their work, social activities, leisure activities, sleep, and improvement in their overall quality of life.
“This study, in addition to previously published work in this area, establishes that oxybutynin is an effective drug for treatment of hot flashes in patients who have relative or absolute contraindications to hormone-based therapy,” says Dr. Leon-Ferre. “We were surprised by the rapidity of the response and the magnitude of the effect, considering the relatively low dose of the drug.” He says that oxybutynin does not interfere with the metabolism of tamoxifen, which is an important consideration for breast cancer survivors, as some of the most effective non-hormonal treatments for hot flashes (e.g. antidepressants) are thought to potentially decrease the efficacy of tamoxifen.
The study was funded by the Breast Cancer Research Foundation.
About Mayo Clinic Cancer Center
As a leading institution funded by the National Cancer Institute, Mayo Clinic Cancer Center conducts basic, clinical and population science research, translating discoveries into improved methods for prevention, diagnosis, prognosis and therapy. For information on cancer clinical trials, call the Clinical Trials Referral Office at 1-855-776-0015 (toll-free).
About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, comprehensive care to everyone who needs healing. Learn more about Mayo Clinic. Visit the Mayo Clinic News Network.

12/17/2018

Benefits of statins far outweigh risks
Reuters (12/10/18) Carroll, Linda

After extensive review of the evidence, the American Heart Association (AHA) has issued a scientific statement confirming the cardiovascular benefits of statin therapy. The protection the cholesterol-lowering drugs offer against heart attack and stroke far exceed the risks they pose, including minor muscle aches and pains. Severe liver damage can occur but is uncommon, according to the authors of the statement, although not as rare as rhabdomyolysis—the one condition that experts agree warrants immediate termination of statin use. Dark urine the color of coffee may be a sign of this complication, which can lead to acute kidney failure. Otherwise, however, AHA says patients who are worried about what they believe are adverse effects tied to statins should consult a physician before stopping the medication. While adverse effects may occur, even rare serious ones, Gregg Fonarow, MD, asks patients to consider what "adverse effect" might result from not taking statins. "It's a 25 to 50% increased risk of having a heart attack, a stroke or a premature cardiovascular death," says Fonarow, who teaches cardiovascular medicine at the University of California, Los Angeles. He was not involved with the AHA statement, which will appear in Atherosclerosis, Thrombosis and Vascular Biology.

11/13/2018

WHO finds wide disparities in antibiotic use between countries
Regulatory Focus (11/12/2018) Mezher, Michael

There are significant differences in the amount of antibiotics used by countries around the world, according to a new World Health Organization (WHO) report. On the low end of the scale, antibiotic consumption was 4.44 defined daily doses (DDD) per 1,000 residents per day in Burundi. The rate was 64.41 DDD/1,000 people in Mongolia, meanwhile. In higher-income countries, the rate was 17.05 DDD/1,000 people in Canada, for example, and 27.68 DDD/1,000 people in South Korea. "The large difference in antibiotic use worldwide indicates that some countries are probably overusing antibiotics, while other countries may not have sufficient access to these life-saving medicines," the WHO noted. The WHO stressed the importance of countries establishing national monitoring systems for antibiotics use and implementing policies to ensure the drugs are used properly. The WHO Report on Surveillance of Antibiotic Consumption also noted varying rates of use among different types of antibiotics. Antibiotics such as amoxicillin and amoxicillin/clavulanic acid—which WHO recommends for first- or second-line treatment for many common infections—were the most commonly used throughout the world. However, broad spectrum antibiotics—which should be used with more caution—also accounted for up to 50% of the antibiotics used in some countries, the report found. Additionally, the report noted that some low- and middle-income nations did not report using antibiotics that WHO has indicated should be used as last-resort options for specific infections or multidrug-resistant bacteria. "This may indicate that some countries may not have access to these drugs that are necessary for treatment of complicated multidrug-resistant infections," the WHO said.

02/22/2018

Just in case you forgot the DOB.

08/14/2017