Dangers of self-medication

Popping pills without a doctor’s prescription, even if the ailment is minor, could have serious repercussions, warns medical expert, Lalitha Suppiah

We often pop pills for common ailments like fever, colds, cough and headache, without bothering to consult a doctor . Self-medication, even for minor ailments, could lead to medical complications. A large number of potent drugs such as pain relievers, cough remedies, anti-allergies , laxatives, antibiotics, antacids and vitamins are sold over-the-counter (OTC). Selfmedication with OTC medicines could cause allergy, habituation, and addiction. For example, excessive use of vitamins can cause hypervitaminosis , or vitamin poisoning. Antimicrobial resistance is a worldwide problem, particularly in India where antibiotics are often available without a prescription. The dangers of self-medication could include the following:

Misdiagnosing the illness:

A minor health issue which could be resolved easily with the doctor’s advice may become a major problem over time. Symptoms may subside temporarily with self-medication , but it would become difficult for a doctor to correctly diagnose and treat later.

Habituation:

You could become addicted to prescription drugs such as antacids, cough syrups and pain relievers.

Allergic reactions:

Some antibiotics such as penicillin or sulpha drugs can cause severe reactions in the body for some people. These could be fatal.

Insufficient dosage:

Incorrect dosage of medicines will not cure and will prolong recovery. On the other hand, over-dosage may damage liver , kidneys and other organs. Indiscriminate use of antibiotics : These could, over a long time, lead to antimicrobial resistance . Consequently, the antibiotic may become ineffective when taken in the future.

Risk of stroke:

The most commonly misused medicines are painkillers. Analgesics can induce gastritis and can also increase risk of stroke by four times in patients with high BP.

 

Drug interactions:

 

Some herbal drugs and medicines may cause drug-to-drug interactions and adversely affect the body.

 

Self-medication by pregnant women:

This could adversely affect the unborn child causing congenital anomalies and birth defects. Unlike other facets of selfcare , self-medication involves the intake of drugs, which have the potential to be beneficial or harmful . Their improper use can have serious health implications, especially among children, the aged, and in people with special physiological conditions such as pregnancy and lactation. The government and health authorities must ensure that only safe drugs are made available OTC. Consumers should be given adequate information about their u

FDA Approves Crizotinib Capsules

On March 11, 2016, the U. S. Food and Drug Administration approved crizotinib capsules (Xalkori, Pfizer, Inc.) for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are ROS1-positive. Crizotinib was first approved in 2011 for the treatment of patients whose tumors are anaplastic lymphoma kinase (ALK)-positive.
The current approval was based on a multicenter, single-arm trial in patients with metastatic ROS1 rearrangement-positive NSCLC.  All patients received crizotinib 250 mg orally twice daily. The efficacy outcome measures were objective response rate (ORR) according to RECIST v1.0 as evaluated by an independent radiology review (IRR) and as evaluated by the investigators. Duration of response (DoR) was an additional outcome measure.
The trial enrolled 50 patients with an age range of 25-77 years whose tumors were prospectively determined to be ROS1-positive by fluorescence in situ hybridization (FISH; 96%) or reverse transcription polymerase chain reaction (RT-PCR; 4%) clinical trial assays. The ORR by IRR was 66% (95% CI: 51%, 79%) with a median DoR of 18 months. The ORR according to investigators was 72% (95% CI: 58%, 84%).
The safety results of this trial were generally consistent with the safety profile of crizotinib evaluated in 1,669 patients with ALK-positive metastatic NSCLC. The most common adverse reactions of Xalkori are vision disorders, nausea, diarrhea, vomiting, edema, constipation, elevated transaminases, fatigue, decreased appetite, upper respiratory infection, dizziness, and neuropathy.
The recommended dose and schedule for crizotinib is 250 mg capsules taken by mouth twice daily.
This application was approved before the Prescription Drug User Fee Act (PDUFA) goal date of April 8, 2016. Crizotinib received Breakthrough Therapy Designation for the ROS1-positive development program and the application was granted Priority Review.  A description of these expedited programs is in the Guidance for Industry: Expedited Programs for Serious Conditions-Drugs and Biologics, available at:http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm358301.pdf.
Full prescribing information is available at:  http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/202570s016lbl.pdf
Healthcare professionals should report all serious adverse events suspected to be associated with the use of any medicine and device to FDAÔÇÖs MedWatch Reporting System by completing a form online athttp://www.fda.gov/medwatch/report.htm, by faxing (1-800-FDA-0178) or mailing the postage-paid address form provided online, or by telephone (1-800-FDA-1088).

High white blood cell ratio linked to recurrence risk in early stage breast cancer

A high ratio of two types of immune system cell is linked to an increased risk of disease recurrence after a diagnosis of early stage breast cancer, finds the first study of its kind, published on the eve of international Women’s Day (March 8) in the online journal ESMO Open.

The finding might guide future treatment and monitoring strategies, if prospective studies confirm the link, say the researchers.

A mounting body of evidence indicates that inflammation has a role in the development and progression of several types of cancer, with studies suggesting that the ratio of neutrophils to lymphocytes, or NLR for short, may be important.

Neutrophils and lymphocytes are white blood cells that are despatched as part of the body’s immune system response to harmful invaders, including cancer cells.

Several studies have reported that a high NLR is associated with a poor outcome in several different types of cancer. But the few studies carried out in women with breast cancer have been inconclusive–possibly because they have included mostly women of Asian ethnicity whose survival is generally longer than that of women from other ethnic backgrounds, say the researchers.

To find out if NLR was associated with disease free survival, the research team tracked the health of 300 white women, all but nine of whom were older than 35, for up to 15 years (1999-2015) following their diagnosis.

All the women had early stage breast cancer, defined as stages I or II, with no spread to other parts of the body.

On the basis of their blood counts taken after diagnosis, but before treatment, 134 of the women had a low NLR (1.97 or lower) and 166 had a high NLR (above 1.97).

After 15 years, cancer had returned in another part of the body in 37 (12%) of the women.

Women with a low NLR fared better at each of the subsequent check-ups at 1, 3, 6, 9, 12, and 15 years, with, respectively, 100%, 98.9%, 91.7%, 82.7%, 82.7%, and 82.7% of them free of recurrence.

This compares with comparable figures of 99.4%, 94.3%, 84.5%, 69.2%, 66%, and 51.4% at the same time points in those with a high NLR.

The researchers undertook further analysis to take account of other potentially influential factors. They found that not having yet gone through menopause, nodes with cancerous cells in the armpit (N1), and a high NLR were independently associated with the risk of recurrence.

To corroborate the findings further, the researchers carried out a propensity score matched analysis–a statistical matching technique that attempts to estimate the effect of an intervention by accounting for the factors that predict receiving it.

This technique was applied to 226 patients (half with a high NLR and half with a low NLR).The results confirmed that not having gone through the menopause, having armpit lymph nodes with cancerous cells, and a high NLR were each independently associated with a worse prognosis.

This is an observational study so no firm conclusions can be drawn about cause and effect, and it was retrospective. But the statistical matching strengthens the associations found, which have also been found in other cancers, say the researchers.

“Despite looking apparently simple, the relationship between NLR and outcome in patients with cancer is probably a complex and multifactorial process [that is] still poorly understood,” write the researchers.

“In simple terms, a high NLR may reflect the key role of systemic inflammation in enhancing angiogenesis [formation of new blood vessels], tumour growth, and development of metastasis [spread],” they say.

ESMO Open Editor in Chief, Professor Christoph Zielinski, comments: “It is inspirational to see the results of this study showing that there may be a potential new way to support women with early breast cancer. We hope that it will encourage more researchers active in this area to establish collaborations around the world with a view to confirming these findings.”


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The above post is reprinted from materials provided by BMJ.Note: Materials may be edited for content and length.

Unconventional treatment strategy controls — rather than eradicates — cancer

Can we learn to live with–rather than kill–cancer? A new study suggests that frequent, low-dose chemotherapy that keeps tumor growth under control may be more effective than standard high-dose chemotherapy that seeks to eradicate cancer cells completely. The treatment strategy, which was tested in mice, flies in the face of conventional cancer therapy, which generally hits patients with the maximum drug dose possible to kill off the largest number of tumor cells.

Despite aggressive treatment, complete cancer eradication is rare and toxic side effects all too common. Recently, researchers have questioned the benefits of standard chemotherapy because while it destroys drug-sensitive tumor cells, it leaves behind drug-resistant cells. By eliminating the former population of tumor cells, the drug allows resistant cells to take over and drive tumor growth uncontrolled.

Taking into account the evolutionary forces that drive cancer resistance, Pedro Enriquez-Navas and colleagues designed an evolution-based treatment strategy that adjusts the drug dose based on how the tumor responds. Rather than trying to shrink the tumor completely, the so-called adaptive therapy seeks to stabilize the tumor by maintaining a small population of drug-sensitive tumor cells to suppress the growth of resistant cells.

The researchers tested the approach with the chemotherapy drug paclitaxel in mice with two different types of breast cancer. Standard chemotherapy shrunk the mouse breast tumors, but only to have them grow back as soon as treatment stopped. Another treatment regimen that skips doses whenever the tumor shrunk also inevitably resulted in tumor progression.

In contrast, adaptive therapy consisting of high initial drug doses followed by progressively lower doses as the tumor responded was more effective in controlling tumor growth than either standard therapy or dose skipping.

In fact, the treatment allowed between 60 and 80% of the mice to be weaned off the drug completely without relapsing for an extended period of time. A related Focus by Giannoula Klement discusses how the study’s eco-evolutionary model of cancer may prompt researchers and clinicians to rethink current therapeutic strategies for cancer.


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The above post is reprinted from materials provided byAmerican Association for the Advancement of Science.Note: Materials may be edited for content and length.