Posted by Paul Rega, MD — published on March 26th, 2008
Postings 710, 736, 737, 738, 740
The FDA just came out this “Alert” to you and the public. It’s a warning not to take Blue Steel and Hero. These are unapproved through-the-Internet drugs that sad, lonely, depressed, flaccid men take to enhance, ahem…their virility. Anyway, these drugs contain a sildenafil-like chemical that, if taken while a person is on nitrates, may make his blood pressure drop lower than Bush’s popularity. Also, it underscores the necessity to ask the patient about ALL the medications he or she is taking; not just the prescribed ones.
A Rochester, NY study about old people (n=277) connects long “boarding” times (> 6 hours) in the ER with a greater risk of winding up in a nursing home ( 18% vs. 4%). Ten percent of these patients overstayed their ER welcome for more than 48 hours. It sounds like what they’re trying to say is that a certain segment of patients never got admitted into the hospital, but just “vegged” in the ER until disposition was made to a nursing home. BTW, I’m not sure what’s worse: staying in an ER for 48 hours, withering in a nursing home, or just living in Rochester?
Hillary’s people came out with the notice that doctors “deserve higher Medicare fees…” They made that statement as they were under heavy sniper fire in the rice fields of Pennsylvania! One way of accomplishing this is by increasing taxes on the wealthy. Kind of like robbing Peter to pay…uh…er…Peter!
I try not to proselytize about disasters and pandemics, but this article from the NY Times gives you some idea of what public health experts are discussing regarding the allocation of scarce ventilators during a pandemic. Depending on factors, you might get one and then again, you might not. You might be on one, but if you’re not getting better, you might lose it. This is coming from NY State, but there is a similar conceit in California and I know that Ohio is working on something like this. You want to know what I’d do? Out-of-luck would be those with chronic back pain, those with more than 15 prescribed medicines, and lawyers .
Coming off “World TB Day,” here are brief descriptions of MDR-TB and XDR-TB.
The Welsh want to remove all bad things from their hospitals’ vending machines (chocolate, sugary pop). Unhealthy, don’t you know. Imagine what they would say if they knew some American hospitals serve MacDonald’s!
Posted by Paul Rega, MD — published on March 26th, 2008
Postings: 730, 732, 734, 735, 739.
This MedScape report cites treatment recommendations by the American College of Obstetricians & Gynecologists for uncomplicated cystitis and pyelonephritis in non-pregnant women. Three days of specific antibiotics for cystitis. 14 days for pyelonephritis if being discharged. The chosen therapies are included in this posting.
http://omniphysicians.com/2008/03/24/new-guidelines-for-management-of-urinary-tract-infection-in-nonpregnant-women/
We’re letting service animals and feel-good animals all over the hospitals. Once, someone at TTH ER said, “Look at that dog!” I said, “Oh, she’s not so bad. She’s an excellent nurse” Until I found out he was talking about a canine visitor. So I guess people weren’t bothered by someone bringing in a horse to cheer up a patient. Now, this didn’t happen in Romania or Botswana. It happened in Hawaii.
http://omniphysicians.com/2008/03/24/oh-no-hi-yo-silver/
Properly-dosed amoxicillin (once a day) is as effective as penicillin for strep throat. The study comes out of New Zealand. No, the study subjects weren’t koala bears!
http://omniphysicians.com/2008/03/25/amoxicillin-for-strep-throat/
A recent paper denounced the use of antibiotics for the vast majority of sinusitis. However, The American Academy of Otolaryngology — Head and Neck Surgery put out its advisory that antibiotics shhould be given if symptoms are going on for 10 days.
http://omniphysicians.com/2008/03/25/sinusitis-the-controvery-continues/
Florida is trying to get a bill passed that will limit the medical liability of those who are on-call for emergencies. It’s not clear if that bill will also limit the liability of ER docs, but emergency physicians down there are backing it.
http://omniphysicians.com/2008/03/25/florida-tries-to-limit-er-care-liability/day loans pay aceschopol loans acsand loan action mortgagea bill to add calendar loan2bloans 2bfha alloans business alabama smallpersonal loan bad with alaska creditloans home albuquerque Map
Posted by Paul Rega, MD — published on March 26th, 2008
FDA Press Release, 3/25/08: The U.S. Food and Drug Administration is advising consumers not to purchase or use “Blue Steel” or “Hero” products marketed as dietary supplements throughout the United States because they are considered unapproved drugs and have not been proven to be safe or effective. These products contain undeclared ingredients, which may dangerously affect a person’s blood pressure level.
These products are promoted and sold over the Internet for the treatment of erectile dysfunction (ED) and for sexual enhancement. They’re touted as “all natural” and labeled as dietary supplements. However, Blue Steel and Hero products do not qualify as dietary supplements because they contain undeclared and unapproved substances that are similar in chemical structure to sildenafil, the active ingredient in Viagra, an FDA-approved prescription drug for ED.
“Because these products are labeled as ‘all natural dietary supplements,’ consumers may assume that they are harmless and pose no health risk,” said Janet Woodcock, M.D., director of FDA’s Center for Drug Evaluation and Research. “But an unsuspecting consumer with underlying medical issues may take these products without knowing that they can cause serious side effects and interact in dangerous ways with drugs that a consumer is already taking.”
The undeclared ingredients in these products may interact with nitrates found in some prescription drugs (such as nitroglycerin), and can lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates. ED is a common problem in men with these medical conditions. Because they may have been advised against taking ED drugs, these men may seek products like Blue Steel and Hero because the products are marketed as “all natural” or as not containing the active ingredients in approved ED drugs.
FDA chemical analysis revealed that both Hero and Blue Steel contain substances that are similar in chemical structure to sildenafil; however, they are not components of an FDA approved drug. Additionally, the products’ label do not list any of these substances.
The FDA advises consumers who have used either of these products to discontinue use and consult their health care professional if they have experienced any adverse events that they feel are related to the use of these products. Consumers and health care professionals can report adverse events to the FDA’s MedWatch program at 800-FDA-1088 or online at www.fda.gov/medwatch/report.htm. The FDA recommends that consumers should talk to their health care professional about FDA‑approved treatments for erectile dysfunction. The FDA may take further regulatory actions to protect consumers from these illegal products.
Blue Steel is sold in bottles containing 10 blue capsules or blister packs containing two blue capsules. Hero is sold in blister packs containing two blue capsules. Both products distributed by Active Nutraceuticals or the Marion Group, Carrollton, Ga.
For more information, visit: http://www.fda.gov/consumer/updates/erectiledysfunction010408.html
