Pharma Weblog

A GP has designed a way to help patients understand why they are taking particular medications.

Dr Nigel Masters, from Hazlemere, Buckinghamshire, adds phrases such as "to lower cholesterol" to prescriptions.

He said it helps patients, particularly those on a number of drugs, understand why they should keep taking them.

Developing Patient Partnerships said the idea would help people be more involved in looking after their health.

The idea has been nominated for this year's Medical Futures Innovations Awards.

Dr Masters had the idea for labelling drugs with the reasons they were being given around three years ago when he was writing out repeat prescriptions for elderly people and having to double-check what some of them were for.

"I thought 'if I can't remember, how can the patient?'"

"Patients were taking these medications on trust, and compliance can be an issue.

"But people need to know why they are taking something."

Dr Masters began by putting information on repeat prescriptions for the elderly.

He then added explanations to prescriptions for people with diabetes and asthma, before deciding to expand the idea to all those who needed repeat prescriptions.

Health checks

Dr Masters has compiled a list of almost 600 drugs and reasons for taking them.

For example, a prescription for the drug amlodipine carries the label "to lower blood pressure". Diclofenac gel can be given "for arthritis pain".

Where conditions may be more sensitive, the wording is less direct.

The cancer drug tamoxifen carries the explanation "to prevent recurrence of disease" while sildenafil, better known as Viagra (Sildenafil Citrate), is labelled "to prevent ED" - erectile dysfunction.

Prescriptions also carry health check reminders. So a prescription for the contraceptive pill will say "check blood pressure yearly", reminding the doctor, patient and pharmacist of the need for regular tests.

Dr Masters said patient confidentiality was an issue.

He said patients could choose not to have the explanations on their prescriptions.

But he added: "Very few have done so. And this idea has been well received by staff here and at the pharmacy."

Dr Masters, whose five-doctor practice has 5,800 patients, said: "Virtually every repeat prescription in the practice now has this labelling."

He said that for the scheme to be more widely used, the system needed to be computerised so more practices could make use of it.

"It needs to be an automated and standardised system."

His idea has already won an enterprise award voted for by GPs.

Dr David Wrigley, a GP from Lancashire and deputy chairman of the Developing Patient Partnerships, said: "This simple approach offers patients the opportunity to be more involved with their health and to take more control over managing their medicines as well as improving safety.

"There may issues around confidentiality but the control this gives to people could far outweigh these concerns."

Originaly from Source

WASHINGTON - Patients who suffer from a rare disease that causes continuous high blood pressure in the arteries of the lungs received a new treatment choice Friday.

The Food and Drug Administration

Food and Drug Administration said it approved Letairis to treat pulmonary arterial hypertension. The condition causes continuous high blood pressure in the arteries that carry oxygen-poor blood from the heart to the lungs. As the arteries narrow, the heart must pump harder, which weakens it with time. The disease affects about 100,000 people in the United States.

The drug, known generically as ambrisentan, is made by Gilead Sciences Inc., based in Foster City, Calif. The company said the drug would be available next week.

The drug comes with strong warnings as it may cause birth defects and shouldn't be used by women who are pregnant or may become pregnant. It also can cause liver damage. Patients taking the once-daily tablets must undergo monthly blood tests to check for injury to the liver, the FDA said.

A second pharmaceutical company, Encysive Pharmaceuticals Inc., was awaiting word on whether its drug to treat the same condition had been approved. The status of that drug, Thelin, or sitaxsentan sodium, wasn't immediately clear Friday. An FDA spokeswoman referred questions on the drug's status to the company. A spokesman said the Houston company had heard nothing.

Other approved medications to treat the condition include Tracleer and Revatio, a lower dose of the same key ingredient in the impotency pill Viagra (Sildenafil Citrate).

Originaly from Source

Men have been given unrealistic expectations of the benefits of Viagra (Sildenafil Citrate), researchers have said.

Erectile dysfunction sufferers who took the drug but found it did not work were left demoralised.

A study of 40 men by the Royal Hampshire Hospital, published in the British Medical Journal, showed most had high hopes for the treatment.

The media's "sensational reporting" of Viagra (Sildenafil Citrate) was blamed for the distress caused when it failed to work.

Researchers interviewed a random sample of 40 men with an average age of 52 who had been prescribed Viagra (Sildenafil Citrate) and had attended a men's health clinic in the year before the study.

Erectile dysfunction caused serious distress to all those men who suffered from it, with marked effects on their self-esteem and well-being.

There was generally an improvement in well-being when Viagra (Sildenafil Citrate), the generic name for which is sildenafil, was successful. But when it failed the distress was severe.

Fault

Many of the men said this was the fault of media hype.

The researchers at the Royal Hampshire Hospital's men's health clinic said: "The media have had a major effect on expectations of sildenafil, and in retrospect, less sensational reporting would have lowered those expectations to the patients' benefit."

Health professionals also needed to be aware of the extreme distress erectile dysfunction could cause, they said.

Ann Tailor, director of the Sexual Dysfunction Association, said: "There was a very high expectation of Viagra. It was portrayed as a wonder drug in the press - take this and get the best sex life.

"For many people who have taken it, it has been safe and effective, but there have been a number of men who it has not worked for."

The reasons why it had not worked were not always understood, she said. The drug should not be taken after food or alcohol and sexual stimulation is still required for it to have the desired effect.

Therapy

Mrs Tailor added that if patients had psychological problems because of the failure of the treatment, or the erectile dysfunction itself, they should seek sexual therapy.

Prof Dinesh Bhugra, at the Institute of Psychiatry in London, said: "There is no doubt that people who invest a lot of hope in a particular kind of treatment, when it does not work, they feel much worse because it makes them stand out.

"They think, if it works for everyone else I must be much worse."

However, the reality was that there were a number of factors in individual cases, both physical and psychological, Prof Bhugra said.

Health professionals should consider a range of treatments suitable to the patient, he said.

Originaly from Source

The anti-impotence pill Viagra could be available over-the-counter drug, it is reported.

The drug's maker Pfizer says it is considering submiting an application to European regulatory authorities to clear it for sale in pharmacies.

An estimated 27 million men have already used the little blue pill for erectile dysfunction on prescription.

Medics said a change would be welcome but might mean other linked diseases were missed with no health check ups.

Ups and downs

Often, men with erectile dysfunction have underlying health problems such as diabetes, which can be spotted by their GP at the time they come for an anti-impotence prescription.

"If men can buy Viagra and rival anti-impotence drugs over-the-counter without a prescription, this opportunity is missed," said Dr David Ralph from the Institute of Urology at University College London.

But there would be benefits too, he said, such as combating the problem of Viagra sold illegally on the internet from unknown sources, which may be fake and if taken with some medicines could be fatal.

He said it would be safe to buy over-the-counter provided the pharmacist did the necessary checks to ensure the medication was suitable for the patient.

Embarrassment factor

It might also be a more attractive option to men as going to see the GP about sexual problems can be embarrassing, he added.

But he cautioned: "There is more to sexual relations than an erection. There may be other problems."

Viagra works by relaxing the blood vessels in the penis. This allows blood to flow into the penis causing an erection.

However, the drug is not an aphrodisiac and does not increase sex drive.

It is licensed only as a treatment for men who have been diagnosed by a doctor as having impotence.

Also, some men, such as those with severe heart disease or low blood pressure, should avoid it because of possible risks and side effects.

Viagra is not licensed for use in women and its safety in women has not been established.

A Pfizer spokesman said: "As with many of our products, Pfizer has routinely evaluated a number of options including different formulations, new indications, over-the-counter and continues to do so."

He added that despite speculation there were no plans to pursue a spray version of the drug.

Originaly from Source

WASHINGTON (Reuters) - The male impotence drug Viagra (Sildenafil Citrate) may be useful for treating jet lag as well, according to Argentine researchers who gave it to hamsters made to feel like rodent globe-trotters.

The researchers manipulated the schedule of turning lights on and off to induce jet lag in the laboratory animals, they reported Monday in the Proceedings of the National Academy of Sciences

National Academy of Sciences.

Adult male hamsters given Viagra, also called sildenafil, recovered from jet lag up to 50 percent faster than hamsters that were not given it, the researchers said.

The scientists stopped giving the hamsters the highest dose they had been using in the experiment due to a certain side effect.

"However, we used the intermediate dose for the rest of the experiments because at that dose animals did not manifest the effects of sildenafil-induced penile erections," they wrote.

Flying across multiple time zones can confuse one's sleep-wake cycle, resulting in the condition called jet lag, marked by insomnia, sleepiness and difficulty concentrating.

Researchers Patricia Agostino, Santiago Plano and Diego Golombek of the Universidad Nacional de Quilmes in Buenos Aires gave doses of Viagra to the hamsters at night, then switched on bright lights six hours early to simulate eastbound flight.

They judged how well the hamsters adjusted to the changes by observing when they began running on exercise wheels.

The drug helped the rodents cope with jet lag only when given before the equivalent of an eastbound flight, not the reverse when they delayed turning on lights to simulate westbound travel, the study found.

The researchers said the findings suggested that Viagra could be useful to help people cope with jet lag or shift work. They said the dose needed for such uses could be lower than the one used for treatment of erectile dysfunction.

Viagra interferes with an enzyme that lowers levels of a naturally occurring compound that plays a role in the regulation of the circadian cycle, the body's internal clock, the researchers said.

Viagra is marketed by Pfizer, the world's largest drug maker. The U.S. Food and Drug Administration" /> News | News Photos | Images | Web

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Food and Drug Administration approved it to treat erectile dysfunction in 1998. More…

Erectile dysfunction is the repeated inability to get or keep an erection firm enough for sexual intercourse.

Due to the sensitive nature of the condition, it is difficult to estimate how many men it affects.

However, it is believed about 5% of 40-year-old men and up to 25% of 65-year-old men may have the condition.

How does an erection occur?

The penis contains two chambers full of spongy tissue called the corpora cavernosa.

When a man becomes sexually aroused impulses from the brain and local nerves cause muscles in the corpora cavernosa to relax, allowing blood to flow in and fill the spaces within the tissue.

This creates pressure in the corpora cavernosa, making the penis expand.

A membrane called the tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection.

The erection is lost when the muscles contract to stop blood flowing into the penis, and open outflow channels.

What causes erectile dysfunction?

A successful, sustained erection requires a sequence of events to occur in a precise fashion.

Anything which disrupts this sequence can lead to problems either getting, or keeping an erection.

The most common cause of erectile dysfunction is damage to the tissues, either the nerves, arteries, muscles or fibrous tissue.

This is often linked either to disease. Conditions such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis and cardiovascular disease account for around 70% of cases of erectile dsyfunction.

In some cases the condition is caused by damage to the nerves and arteries near the penis which can occur during surgery, particularly for prostate and bladder cancer.

Physical injury to the penis, spinal cord, prostate, bladder or pelvis can also be a factor.

Erectile dsyfunction is also a side effect of some common medications, including blood pressure drugs, antihistamiines, antidepressants and tranquilizers.

Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause up to 20% of cases.

Smoking, which affects blood flow, has also been linked to the condition.

Can it be treated?

Yes. There is a range of ways to treat erectile dysfunction.

Doctors will consider psychotherapy for patients who are likely to benefit, but alternatives include drugs, vacuum devices, and surgery.

Drug Therapy:

One drug in particular, Viagra (Sildenafil Citrate), has become an international phenomenon since its launch in the late 1990s.

The drug, also known as Sildenafil, does not directly give a man an erection. It works by boosting the natural mechanism that leads to an erection.

When a man is sexually aroused, certain tissues in his penis relax. This allows large amounts of blood to flow into the muscle, thus producing an erection. Viagra helps by elevating the levels of the chemical that causes the tissues to relax.

These effects were discovered accidentally. The drug was originally developed to improve blood supply to the heart in angina sufferers.

In a small number of cases, people who have taken Viagra have complained of headaches, flushing and stomach-ache.

It can also cause some visual problems, including an increased sensitivity to light, blurred vision or an inability to tell the difference between blue and green. Men who are already taking medicines that contain nitrates, such as nitro-glycerine, are strongly advised not to use Viagra because the combination can lower blood pressure too much.

Another drug, Levitra (Vardenafil), works first time for nearly nine out of 10 men (87%) who are experiencing erection difficulties.

Penile injections:

The injection of drugs directly into the tissues of the penis to trigger an erection was more common before the advent of new drugs such as Viagra.

The drugs relax muscles and increase blood flow to create an erection.

Vacuum Devices:

These work by creating a partial vacuum around the penis, which draws blood into the organ.

The devices have three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic band, which is placed around the base of the penis to maintain the erection after the cylinder is removed and during intercourse.

Surgery:

There are different types of surgery:

Implanted devices, known as prostheses, can restore erection in many men.

These can come in different forms. For instance, paired rods can be inserted into the corpora cavernosa to enable the user to manually adjust the position of the penis.

Alternatively, inflatable cylinders can be inserted inside the penis and expanded using pressurized fluid.

In some cases doctors may attempt to repair blockages in damaged arteries. However, this usually only works if the blockages are not widespread.

It is also possible to tie off veins to reduce the leakage of blood that can reduce the rigidity of an erection. However, experts have raised questions about the long-term effectiveness of this procedure, and it is rarely done.

This page contains basic information. If you are concerned about your health, you should consult a doctor.

Originaly from Source

Viagra could be used to help people flying eastwards recover from jetlag, animal research suggests.

A team of Argentine scientists found the drug helped hamsters recover up to 50% faster from forward shifts in their daily time cycles.

However, the drug only worked in conjunction with light therapy, and only in one time direction - the equivalent to flying eastbound.

The study features in Proceedings of the National Academy of Sciences.

In mammals, the light-dark cycle regulates the body's biological clock, which promotes activity during the daytime, when it is light, and sleep at night.

Time shift

The researchers from the National University of Quilmes shifted the light-dark cycle of hamsters six hours forwards, by switching on lights six hours earlier than usual.

They then monitored the hamsters' running wheel activity to assess when their body clocks had adjusted to the new time cycle - the hamsters are active in the day but stop running when the lights go out.

Injection of Viagra before the time shift meant the hamsters adjusted to the new time cycle faster, even when low doses of the drug, which did not cause penile erections, were used.

Viagra, the drug sildenafil, was originally developed for the treatment of high blood pressure and angina, and is used to treat erectile dysfunction.

Viagra used in combination with light could help jetlag symptoms

When used without the shifts in light, the drug did not induce changes in the hamsters' activity, so it seems to work by enhancing the light-induced response.

Dr Diego Golumbek, who led the research, said the drug seemed to work via a molecule called cGMP which is known to have a role in setting the body's time clock - it is present at higher levels during the day.

The Viagra blocks the activity of an enzyme which breaks down cGMP, allowing higher levels to build up.

One direction only

Dr Golumbek said the fact that different mechanisms may be used to slow down and speed up the body clock explains why Viagra only worked when the lights were switched on early, not late.

Professor Robert Lucas, from Manchester University, said although looking for ways adjust biological clocks was important, regulating light exposure was the most widely accepted strategy for doing this.

He said the new research raised the possibility of using Viagra in conjunction with this light treatment, but he added: "We will have to wait for more research to know whether this will work in humans."

Pfizer, the makers of Viagra, said the drug should only be used in accordance with the approved labelling.

Originaly from Source

The anti-impotence pill Viagra could be available over-the-counter drug, it is reported.

The drug's maker Pfizer says it is considering submiting an application to European regulatory authorities to clear it for sale in pharmacies.

An estimated 27 million men have already used the little blue pill for erectile dysfunction on prescription.

Medics said a change would be welcome but might mean other linked diseases were missed with no health check ups.

Ups and downs

Often, men with erectile dysfunction have underlying health problems such as diabetes, which can be spotted by their GP at the time they come for an anti-impotence prescription.

"If men can buy Viagra and rival anti-impotence drugs over-the-counter without a prescription, this opportunity is missed," said Dr David Ralph from the Institute of Urology at University College London.

But there would be benefits too, he said, such as combating the problem of Viagra sold illegally on the internet from unknown sources, which may be fake and if taken with some medicines could be fatal.

He said it would be safe to buy over-the-counter provided the pharmacist did the necessary checks to ensure the medication was suitable for the patient.

Embarrassment factor

It might also be a more attractive option to men as going to see the GP about sexual problems can be embarrassing, he added.

But he cautioned: "There is more to sexual relations than an erection. There may be other problems."

Viagra works by relaxing the blood vessels in the penis. This allows blood to flow into the penis causing an erection.

However, the drug is not an aphrodisiac and does not increase sex drive.

It is licensed only as a treatment for men who have been diagnosed by a doctor as having impotence.

Also, some men, such as those with severe heart disease or low blood pressure, should avoid it because of possible risks and side effects.

Viagra is not licensed for use in women and its safety in women has not been established.

A Pfizer spokesman said: "As with many of our products, Pfizer has routinely evaluated a number of options including different formulations, new indications, over-the-counter and continues to do so."

He added that despite speculation there were no plans to pursue a spray version of the drug.

Originaly from Source

Thanks to its unusual status as a US self-governing commonwealth, the island's four million residents elect their own government, while enjoying most of the economic benefits of being American.

Puerto Rico's currency is the US dollar; its citizens are entitled to US passports, but they do not pay most federal taxes. Thanks to long and historic ties to cities like New York, many are bilingual and feel as assimilated as they want to be with the US mainland.

But when it comes to the economy, it is clear that the real power to shape Puerto Rico's future often lies in the hands of multinational corporations and the US Treasury.

Barceloneta is a coastal town of just over 20,000 residents - about 40 minutes drive west of the capital San Juan. Twenty years ago it was best known for the juiciness of its pineapples, but now it is a pharmaceutical hub, and home to America's only factory making Viagra - Pfizer's impotence drug.

Hi-tech community

Taking the turning for Barceloneta it is clear from the skyline that things are booming. Apart from the landscaped factories, the town's colourful and gleaming shopping mall - which opened five years ago - stands out against the rich green of tropical forest on the horizon.

Walk into the huge restaurant area at lunchtime, and you find hundreds of well-heeled employees from the four multinational companies that have a base in the town.

"The good thing about having so many pharmaceutical companies on the same site is that we're a high-technology community here," said one Pfizer chemical engineer.

She was keen to steer conversation away from the little blue Viagra pills which have replaced pineapples as the town's best known export, but admitted that when she mentioned her employer's name, friends would smile and ask about the sex drug.

Pfizer's most vocal advocates in the town can be found in the mayor's office. I drove up to the gates of their plant on the outskirts of Barceloneta, in a shiny pick-up belonging to the deputy-mayor, Lisandro Reyes. He pointed out two new schools and row after row of new housing lining the route.

"Pfizer is a great partner here in Barceloneta. We're proud of all the drugs made here, including Viagra," he said.

"It's a resource for the elderly, or the young. We're bringing some happiness around the world for couples who enjoy Viagra as a means of getting their love life in order," he added with a grin.

The other Fortune 500 firms with plants here include Bristol-Meyers Squibb, Merck Sharp & Dome and Abbott Laboratories - making up a specialist workforce of around 8,000 people.

These firms located here thanks to tax incentives and duty-free access to the US market. Puerto Rico's import and export figures have doubled since the late 1980s, and the economy has transformed from agricultural to industrial in a generation.

Economic fears

But without any substantial natural resources of its own, the island depends on the business and investment it can attract from the mainland.

More than 90% of its exports go there, and many economists worry that beyond growth areas like Barceloneta sustainable development is not being encouraged enough.

The influential Caribbean Business journal sounded a terse warning last week:

"Slow economic growth, low personal income, inability to create jobs in the formal economy, a greying population, a growing fiscal deficit, high public debt-burden per capita, and huge government subsidies, further aggravate the issues that are plaguing the economy."

Downtown Barceloneta shows a different face of the town

Pfizer's local-born vice president for manufacturing in Puerto Rico, Carlos del Rio, said he was proud the company had helped to forge a "middle class" in the Barceloneta area, creating around three jobs in the community for each job at the company.

Directly and indirectly, they have helped fund Barceloneta's entire infrastructure, from the fire department to a state-of-the-art sewage treatment facility.

The company's contributes around $12m to the town's annual budget.

Complaints

While most people I spoke to were glad of the cash influx, which is about to manifest itself further with the widening of the town's high street, there were some sceptics.

Ivan Arocho, who runs one of the town centre's many pharmacies is one: "We make pennies, they make money," he said with a sigh. He's been in the town for more than 20 years, and liked it better in the old days, before the factories came.

"It's made jobs, but there's lots of air contamination. A lot of people complain," he added.

Mr Reyes says strict federal laws on emissions provide adequate safeguards for the environment.

"With Viagra and tequila, grandma is happy," reads a restaurant slogan

A greater threat to the town's economic growth comes in the form of the macro-economic uncertainties that lie ahead. Mr Reyes said he was confident that attractive tax incentives and investment deals would help to deepen development for decades to come, but local executives cannot make guarantees.

"It's always being looked at. Puerto Rico is very competitive. We've tried to continually invest in our plants," said Mr del Rio, addressing the possibility that the corporate headquarters might make the decision to move on at any time, to keep costs low.

Viagra's patent will expire in a few years' time, and all the plant can do is continue to perform successfully.

"We're in a competitive environment, so the answer to all that is that our job is to try to remain as competitive as possible."

Originaly from Source

Italian police have seized 80 race horses which had been given performance-enhancing drugs, including male potency booster Viagra.

The horses and 10,000 packages of drugs ranging from hormones and steroids to painkillers, were detained at an illegal training centre near Naples.

About 40 people, including horse owners, vets and pharmacists were being investigated, police said.

They said the drugs were believed to have come from abroad.

Reports say Viagra can improve a horse's cardio-respiratory functions and its performance if taken before races.

Police commander Mario Pantano told local television: "We are able to ascertain the use of the famous Viagra to increase the performance of these horses."

The property seized by police, including the track and its horses is reported to be worth around five million euros (3.4m).

The investigation started in 2004 to look into irregularities within the official horse-racing industry, focusing in particular the illegal use of drugs and secret betting.

Originaly from Source