Insulin is one of the top 10 high risk medications worldwide for prescription errors

Insulin has been identified as one of the top 10 high risk medicines worldwide. Errors are common - the first national audit in England and Wales showed prescribing errors in 19.5% of cases.

Not only are mistakes common, they often lead to harm - 3% of medication errors are related to insulin, but these errors were also twice as likely to cause harm as errors for other prescribed drugs.

Errors relating to insulin arise because insulin has a narrow therapeutic range and requires precise dose adjustments with careful administration and monitoring.

Over 20 different types of insulin are in use, in various strengths and forms, and with a range of delivery devices, including insulin syringes (from vials), insulin pens (prefilled or reusable), or infusion pumps.

References:

Safer administration of insulin: summary of a safety report from the National Patient Safety Agency. BMJ 2010; 341:c5269 doi: 10.1136/bmj.c5269 (Published 13 October 2010).

Image source: Wikipedia, public domain.

Don’t just swallow, check the evidence first - it applies to diet, medications, and more

The wrong approach

According to the food conglomerate Danon: “Evidence is increasing that even mild dehydration plays a role in the development of various diseases.” It’s a campaign, sponsored by the producers of Volvic, Evian, and Badoit bottled waters, to get us all to drink more water.

But what and where is this evidence? A doctor replies: “This is not only nonsense, but is thoroughly debunked nonsense.”

The right approach

Worried by the fact that European guidelines classified almost all older people as being at high risk of cardiovascular disease, Norway has developed its own guidelines that use differential risk thresholds according to age.

Compared with the European guidelines, the total sum of life gained is about the same, but the number of patients treated is considerably lower.

How does clinical evidence work?



Ben Goldacre's Moment of Genius on BBC4 radio:

"Clinical trials in medicine are designed to be free from bias. They test, as objectively as possible, the effectiveness of a particular intervention.

When you bring the results of all these individual trials together, however, how do you weigh up what evidence is relevant and what is not? In 1993, a method of "systematic review" was introduced that enables us to get the clearest possible view of the evidence."

References:

Don’t just swallow, check the evidence first. Godlee 343. BMJ, 2011.

Image source: Plastic bottles before processing. Wikipedia, dierk schaefer, Creative Commons Attribution 2.0 License.

How to Dispose of Medications (video)

Watch this About.com video to learn how to properly dispose of your medications, and protect the environment at the same time.



For more information, check the selected references below:

FDA Consumer Updates > How to Dispose of Unused Medicines http://1.usa.gov/16yTnIf

Safe Disposal of Medicines > Disposal of Unused Medicines: What You Should Know http://1.usa.gov/16yTqnh

New hepatitis C treatment: 2 new medications may increase success rate to 70%

Mayo Clinic: Four million people in the U.S., 100 million worldwide, are infected with Hepatitis C. It's a virus you can get from blood transfusions given before 1990, shared needles, unclean tattoo needles and sometimes sex.

In many cases it leads to cirrhosis of the liver and eventually liver cancer. Standard treatment with interferon and ribavirin only cures about 45% of all patients. But thanks to two new medications, up to 70% of people with hepatitis C may be be cured. More than 40 medications are in development.

Top 10 Most Prescribed Medications

According to a report from the IMS Institute for Healthcare Informatics, the top 10 most-prescribed drugs in the U.S. are:

- hydrocodone (combined with acetaminophen)
- simvastatin
- lisinopril
- levothyroxine sodium
- amlodipine besylate
- omeprazole
- azithromycin
- amoxicillin
- metformin
- hydrochlorothiazide

The top 10 best-selling drugs are:

- Lipitor, $7.2 billion
- Nexium, 6.3 billion
- Plavix
- Advair Diskus, $4.7 billion
- Abilify
- Seroquel
- Singulair, $4.1 billion (it will be generic in 2012)
- Crestor
- Actos
- Epogen

References:
The 10 Most Prescribed Drugs. WebMD.

Image source: Wikipedia, public domain.