Archives for July 9, 2008

DB’s Medical Rants » I love the Wal-mart program

DB’s Medical Rants » I love the Wal-mart program

Dead on.

Black Box Warnings now Officially Useless

FDA to Add Warning to Antibiotics –
July 9, 2008; Page B7

WASHINGTON — The U.S. Food and Drug Administration will seek to add strong warnings about the risks of tendon rupture associated with a class of antibiotics used to treat bacterial infections.

The FDA wants to add black-box warnings, the strongest warning the agency issues, to a handful of drugs, including Bayer AG’s Cipro and Johnson & Johnson’s Levaquin. The move comes six months after the consumer group Public Citizen sued the FDA to require the agency to add black-box warnings to the drugs.

Serious reports of tendonitis and tendon rupture continue to increase with use of the drugs, prompting the FDA to ask companies to add the stronger warnings, the FDA said in a posting on its Web site Tuesday. Such ruptures most frequently involves the Achilles tendon, but also include ruptures of the shoulder, hand, biceps, and thumbs.
(emphasis mine)

Black box warnings used to be for very serious, life-threatening problems in drugs.  Now tendonitis and tendon rupture are life threats, or are so serious they warrant a Black Box?  The elevation of known, well-documented drug side effects to Black Box status dilutes its meaning, and will ultimately require the formation of a new class of warnings.

Tendon ruptures aren’t benign.  Neither are infections.  Name me an antibiotic that wouldn’t rate a black box under the criteria used on the flouroquinolones, then wonder at what’s happened to the FDA.

Epocrates: Go Mobile

Some love for Epocrates.

I used Epocrates on Palms for a few years, then was an early adopter of Epocrates on the Backberry platform, and it had a glitch; they fixed it within a week, and it’s been smooth sailing/computing since (see here).

For those who aren’t using it yet, here’s a starting point: Epocrates: Go Mobile Their site will even help you pick which PDA/Mobile phone is best for you.

I use their free product, so this is essentialy a free endorsement, but here goes:

In this day and age of new drugs, continuously changing warnings, and patients on multiple drugs needing interaction checking, some resource is needed, and Epocrates is an excellent product.  It’s (relatively) easy to install, it will update automatically, and it works.  There are things I’d change if it were my product (like this: look up a drug name that’s been discontinued, you get ‘drug discontinued in the US’, but no link to the generic; I now have to back out, and re-search with the generic name: Dumb.) but for a handy, functional drug reference it’s hard to beat.

I use it, and if you don’t have a drug reference in a PDA, this is one you should look at.