One’s health may be better served by closing the medicine cabinet, according to new studies
The American College of Physicians (ACP) released a new evidence-based clinical practice guideline recommending that physicians and patients treat acute or subacute low back pain with non-drug therapies such as superficial heat, massage, acupuncture, or spinal manipulation. “If drug therapy is desired, physicians and patients should select nonsteroidal anti-inflammatory drugs (NSAIDs) or skeletal muscle relaxants,” states a February news release issued by ACP.
Low back pain – ranging from acute (lasting less than four weeks), to subacute (lasting four to 12 weeks), and chronic (lasting more than 12 weeks) – is one of the most common reasons for all physician visits in the U.S., according to ACP.
For chronic low back pain, the organization recommends initial treatment through non-drug therapy with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, and cognitive behavioral therapy, among other options.
If those options fail, “ACP recommends that physicians and patients consider treatment with NSAIDs as first line therapy; or tramadol or duloxetine as second line therapy.”
“Physicians should consider opioids as a last option for treatment and only in patients who have failed other therapies, as they are associated with substantial harms, including the risk of addiction or accidental overdose,” says Nitin S. Damle, M.D., M.S., MACP, president of ACP. (Repertoire wrote about America’s opioid epidemic – which accounted for over 60 percent of drug overdose deaths in 2014 – in its January 2017 issue.)
According to Damle, “Physicians should reassure their patients that acute and subacute low back pain usually improves over time regardless of treatment.”
For the full ACP news release, as well as a link to the official guideline, visit https://www.acponline.org/acp-newsroom/american-college-of-physicians-issues-guideline-for-treating-nonradicular-low-back-pain.
Why expiration dates matter
Expiration dates on medications are more important than consumers might realize. A February National Public Radio article says that these expiration dates are “based on scientific evidence gathered by the manufacturer showing how long the drug’s potency lasts.
“Companies expose their medications to different environments, different temperatures and humidity levels to see just how long it takes for the medication to degrade to the point that its effectiveness is compromised.”
Pharmacist Mike Fossler of the American College of Clinical Pharmacology tells NPR that taking medications months, or years, after the expiration date is unlikely to cause harm, but also may not help.
For basic ailments like headaches, this may not be a big deal. But “if you’re fighting a bacterial infection with antibiotics like amoxicillin or ciprofloxacin, for example, using less than fully potent drugs could fail to treat the infection and lead to more serious illness,” says NPR. Additionally, using antibiotics that have decreased strength after expiration may allow bacteria to become resistant to them, says Mohamed Jalloh, a pharmacist and spokesman for the American Pharmacists Association.
The article notes that this advice holds true for both prescription and over-the-counter medications. “Check the expiration date before even buying those pain relievers or allergy tablets, some pharmacists advise – the same way you check your milk. Buy the one with the date that’s furthest away.”
Read the full NPR article at this link: http://www.npr.org/sections/health-shots/2017/02/06/513254232/when-old-medicine-goes-bad.
Alzheimer’s disease is the most common form of dementia. Though the causes are uncertain, a January Harvard Health Letter provides several healthy habits people can adopt that seem to help prevent it.
The first recommendation is to exercise. “The most convincing evidence is that physical exercise helps prevent the development of Alzheimer’s or slow the progression in people who have symptoms,” says Gad Marshall, M.D., associate medical director of clinical trials at the Center for Alzheimer Research and Treatment at the Harvard-affiliated Brigham and Women’s Hospital.
Marshall says that the recommendation is 30 minutes of moderately vigorous aerobic exercise, three to four days per week. (The American Heart Association already recommends 30 minutes of exercise five days a week, to improve cardiovascular health.)
The second recommendation is to eat a Mediterranean diet. This type of diet includes fresh vegetables and fruits; whole grains; olive oil; nuts; legumes; fish; moderate amounts of poultry, eggs, and dairy; moderate amounts of red wine; and, sparingly, red meat. “A recent study showed that even partial adherence to such a diet is better than nothing,” says Marshall.
The third recommendation is to get enough sleep. Marshall recommends seven to eight hours per night.
Harvard also notes some, “but not enough,” evidence that three additional lifestyle choices may help prevent Alzheimer’s. These choices include:
- Learning new things.
- Connecting socially.
- Moderating alcohol intake.
The best advice, says the article, is for people to make as many healthy lifestyle choices as they can. “They’re all beneficial,” says Marshall, “and if they help you avoid Alzheimer’s, all the better.”
To view the full Harvard Health Letter, visit this link: http://www.health.harvard.edu/alzheimers-and-dementia/what-can-you-do-to-avoid-alzheimers-disease?utm_source=delivra&utm_medium=email&utm_campaign=WR20170213-WorkoutWB&utm_id=395858&dlv-ga-memberid=32408512&mid=32408512&ml=395858.