I Was Given the Wrong Rx. How to Stop a Pharmacy Mix-Up from Happening to You

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Two weeks ago, I called in a refill of a medication I had recently started taking. Then the pharmacist left me an urgent voicemail asking me to call her “right away.” When I did, she gave me some seriously unsettling news: I had unwittingly been popping the wrong medicine—one with a very similar name to the drug I had actually been prescribed—for four weeks.

You know how prescriptions are supposed to work: Your doctor pulls out his pad or e-prescribes your Rx. Either way, the pharmacist fills one of those little orange bottles with your correct medication, in the proper dose.

RELATED: 15 Tips for Saving Money on Prescription Drugs

But that’s not always what happens. An overworked pharmacist could misinterpret your doctor’s messy scrawl (one woman we know was handed herpes medication instead of her lupus drug), accidentally give you an Rx meant for another patient with a similar name, fill the bottle with 250 mg pills instead of 25 mg ones, or print a label instructing you to take the medicine too often—or not frequently enough.

The impact of mine, luckily, was pretty minimal. Both drugs (the one I was taking and the one I was supposed to be on) work in similar ways. I hadn’t received a dangerously high dose. And the condition I was treating—recurrent kidney stones—was not life threatening or even particularly urgent.

RELATED: 15 Weird Risk Factors for Kidney Stones

But pharmacy errors can have serious, even fatal, repercussions. The family of a Florida woman won more than $33 million in 2010 in a wrongful death lawsuit against a national drugstore chain. The pharmacy had allegedly dispensed her blood thinner for breast cancer at 10 times the correct dosage, leading to a brain hemorrhage that forced her to stop the cancer treatment.

In another case of mixed-up meds, a different national chain apologized for doling out the breast cancer drug Tamoxifen to some children in New Jersey who had been prescribed fluoride (fortunately, nobody was seriously harmed).

So what can you do to protect yourself? Follow these simple steps from pharmacist Allen Vaida, executive vice president of the Institute for Safe Medication Practices (ISMP), a nonprofit dedicated to preventing drug errors.

In the doctor’s office

1. Know exactly what you’re on. “Electronic prescribing is a good thing in that it’s decreased a lot of errors with penmanship,” Vaida says, “but on the downside, patients don’t have any paper copy of what they’re supposed to be getting.” Always ask your doctor to write down the name of the drug (and its generic version), the dosage, and any instructions.

2. Make sure your doctor includes why you need the med. The name of your medication may be super similar to that of another drug, but if one treats high blood pressure and one anxiety, your pharmacist will know which is for you. (And you can double check with this handy chart of confused drug names.)

At the pharmacy

3. Open the bag. “Don’t walk out with the bag still sealed or stapled,” Vaida advises. “It’s one of the simplest things you can do, but we’ve found that it can prevent more than 50 percent of errors.” If you see another patient’s name on the label, or the pills look different than you remember, stop and ask the pharmacist to review it.

4. Stop and chat. Pharmacists are required to provide medication counseling for Medicare patients; in some states, this consult is mandatory for all. Still, “sometimes people will sign off without actually receiving it,” Vaida says. “But counseling is often what will flag an error, especially with a new prescription. The pharmacist might say ‘So this is going to help control your diabetes,’ and the patient responds, ‘Huh? I don’t have diabetes.’” Many drugstores now have a private area, so you don’t have to ask about your yeast treatment with a line of people behind you.

RELATED: 7 Safe Off-Label Uses for Over-the-Counter Meds

Back at home

5. Be alert. If your meds taste different than you expect, or you have the wrong number of pills, call the pharmacy. And definitely speak up if you notice unexpected side effects or the drug doesn’t seem to be doing the job (for example, that rash won’t clear). You can also check the National Library of Medicine’s Pillbox (pillbox.nlm.nih.gov), which allows you to search drugs by name, imprint (the series of numbers or letters imprinted onto the tablet), or appearance.

6. Blow the whistle.

So what should you do if you a drug mix-up happens to you? Alert both the pharmacy and your physician—even if the mistake was a minor one. “You want them to look at exactly what happened, and make sure it doesn’t happen again,” says Vaida. Also report the incident to your state pharmacy board, as well as the website consumerdrugsafety.org, which is run by the ISMP. “When we see that there’s an error that keeps happening,” he says, “we work with the FDA and the drug manufacturer to help get the labeling changed.”

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Overactive Thyroid Linked to Breast Cancer Risk

By Alan Mozes
HealthDay Reporter

THURSDAY, Feb. 11, 2016 (HealthDay News) — Women who have an overactive thyroid gland might be at greater risk for breast cancer, a new study suggests.

A team of Danish researchers found that women with the condition — called hyperthyroidism — appeared to face an 11 percent increase in their risk for breast cancer, compared to women with a normal-functioning thyroid gland.

On the other hand, women with the opposite problem — a condition called hypothyroidism, where abnormally low levels of thyroid hormones are produced — saw their risk for breast cancer dip 6 percent below that of women with normal thyroids.

But at least one breast cancer expert not involved with the study said she was reluctant to read too much into the study findings.

The findings stem from a 36-year review that identified nearly 80,000 Danish women with an overactive thyroid and more than 61,000 women with an underactive thyroid. All of the women were cancer-free when they entered the study, which ran from 1978 to 2013.

Breast cancer incidence was then tracked for roughly every five to seven years.

Study lead author Dr. Jens Otto Lunde Jorgensen said that while the review followed patients far longer than previous efforts, the new findings aren’t all that surprising. In fact, he noted that “a similar association between overactive thyroid disease and [the] risk of breast cancer in women has been reported in three out of four previous studies.”

At the same time, he stressed that while an overactive thyroid was found to be associated with breast cancer risk, one does not necessarily cause the other, adding that “the possible explanations for this ‘association’ are many.”

“Women with thyroid disease are more likely to see their doctor and to undergo examinations including mammography,” Jorgensen said. “Women with overactive thyroid disease also are predisposed to other diseases such as breast cancer, but it is not the overactive thyroid by itself. Thyroid hormones may contribute to development of breast cancer. [And] treatment of overactive thyroid disease increases the risk of breast cancer. These are all possibilities, but the bottom line is that we do not know for sure.”

Jorgensen, a clinical professor in the department of endocrinology and internal medicine at Aarhus University Hospital in Denmark, and his colleagues report the findings in the Feb. 11 issue of the European Journal of Endocrinology.

The researchers pointed out that the thyroid gland is central to metabolic control. Women are much more likely than men to have an overactive thyroid, a diagnosis faced by approximately 51 out of every 100,000 people every year, researchers said.

Jorgensen added that while thyroid cancer screening is an increasingly common practice, the new finding “does not justify increased screening for overactive thyroid disease.”

According to the U.S. National Library of Medicine, the thyroid is a key hormonal gland that plays a major role in the metabolism, growth and maturation of the human body. It helps to regulate a variety of functions by constantly releasing a steady stream of hormones into the bloodstream.

Dr. Courtney Vito, a breast surgeon and an assistant clinical professor of surgical oncology at the City of Hope Comprehensive Cancer Center in Duarte, Calif., said it would be a mistake to make too much out of the study findings.

“First of all, this is a very homogenous group of women,” she said of the Danish participants. “There would never be a study group like that in the U.S., where there is a lot of ethnic variation and we are a much more heterogeneous population. So, these findings might not be generalizable across other populations.”

“There were also plenty of flaws in the study design,” Vito added. For example, she noted that “high thyroid levels were only shown to have estrogen-like properties in a test tube, not in actual people. And they [the researchers] didn’t take into account family breast cancer histories, and didn’t comment on how bad anyone’s thyroid disease actually was.

“So, I would say that we do know that the endocrine system is much more complex than our current understanding, and that breast cancer is clearly a hormonally driven disease that we clearly need much more [research] to better understand,” she said.

“And this is a study that would make you scratch your head and think this is interesting, and probably worth a second look. But there is certainly nothing conclusive here at all.”

More information

There’s more on breast cancer risk at the U.S. National Cancer Institute.

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Asthma May Raise Risk for Abdominal Aneurysm

By Steven Reinberg
HealthDay Reporter

THURSDAY, Feb. 11, 2016 (HealthDay News) — People 50 and older who have had recent asthma activity appear to be at an increased risk of abdominal aortic aneurysm, a new study suggests.

An abdominal aortic aneurysm is a weak spot in the body’s main artery, the aorta, where it passes through the abdomen. That weak spot can rupture, causing massive bleeding. The researchers also found that people with recent asthma activity were more likely to have an aneurysm rupture compared to those without recent asthma activity.

“People with abdominal aortic aneurysm who were diagnosed with asthma within the past year had more than a 50 percent greater risk of ruptured aneurysms than those without asthma,” said lead researcher Guo-Ping Shi, from Brigham and Women’s Hospital in Boston.

Men diagnosed with asthma within the preceding six months were twice as likely to have an aortic aneurysm rupture, Shi said, adding that the risk was much lower among women.

The researchers also found that use of anti-asthmatic medication in the last six months was linked to a 45 percent raised risk of an abdominal aortic aneurysm.

Shi cautioned that the study only shows an association between asthma, aneurysm and rupture; it doesn’t prove that asthma causes aneurysm or the rupture of an aneurysm.

The study was published online Feb. 11 in the journal Arteriosclerosis, Thrombosis and Vascular Biology.

Abdominal aortic aneurysm is more likely to occur in older men who have other risk factors, such as smoking, high blood pressure, high cholesterol, obesity and emphysema, Shi said.

The aorta carries blood to the whole body. When it becomes weakened it can form a balloon-like bulge that may rupture, he said. Because an abdominal aortic aneurysm rupture can be deadly, Shi recommended that men 50 and older with asthma be checked for aneurysms.

This can be done with a noninvasive ultrasound. And, if necessary, an aneurysm can be fixed with an operation, Shi said.

According to Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital in New York City, “If you have asthma and doubts about whether you have an aneurysm, you can have an abdominal ultrasound. It’s easy and noninvasive.”

For the study, Shi and his colleagues collected data from two national health registries in Denmark. One had information on nearly 16,000 men and women aged 50 and older. About 4,500 of the adults in this group had an abdominal aortic aneurysm, the study said. The second registry had information on 619 people with abdominal aortic aneurysm, along with information on smoking status.

Shi said the most likely culprit behind the association is a specific inflammation-related protein called IgE, or immunoglobulin E, which the body makes in response to allergens.

IgE makes arteries stiff, which can lead to aneurysm, Shi said. If IgE is the culprit, the risk for an aneurysm wouldn’t be confined to asthma, but would include allergies and other allergic diseases, too, because these conditions cause levels of IgE to increase.

The connection between asthma and aneurysm was first seen in animal studies. Mice with asthma developed aortic aneurysms twice as large as those without the disease, Shi said.

Dr. Gregg Fonarow, a professor of cardiovascular medicine and science at the University of California, Los Angeles, said, “Asthma involves inflammatory mechanisms, including mast cells and IgE, and effective treatment of asthma has long involved therapies that target inflammation.”

Recent studies have found that mast cells and IgE can be found in abdominal aortic aneurysms, he said.

“This study provides additional evidence suggesting that inflammation is playing a role in abdominal aortic aneurysms and it may open new lines of research into potential therapies to prevent the development and rupture of abdominal aortic aneurysms,” Fonarow said.

More information

For more on abdominal aortic aneurysm, visit the Radiological Society of North America.

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The Weird Way Looking at Your Phone Can Mess With Your Hearing

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Do you ever get accused of “not listening” because you’re glancing down at your phone? Here is a study that suggests it’s not your fault (sort of).

Research published in the Journal of Neuroscience has revealed that concentrating on a visual task (say, scrolling through your Instagram feed) may render you temporarily deaf to normal-volume sounds (like your friend’s story about … what was she talking about again?)

Related: Here’s What Happens to Your Eyes When  You Look at Multiple Screens 

For the small study, researchers from the University College London analyzed the real-time brain activity of 13 volunteers as they completed visual tasks while sounds played in the background. As the tasks got harder, the brain’s response to sound was reduced.

“The brain scans showed that people were not only ignoring or filtering out the sounds, they were not actually hearing them in the first place, ” study co-author Maria Chait, PhD, explained in a press release. These findings suggest that our vision and our hearing share limited resources in the brain, which is essentially forced to choose between processing info from our eyes or our ears.

Related: 17 Ways to Age-Proof Your Brain 

So-called inattentional deafness  could explain why you miss your bus stop announcement while you’re reading a book, for example. Or why your  boyfriend can’t hear you calling him while he’s watching TV. This phenomenon is a common occurrence in everyday life, co-author Nilli Lavie, PhD, pointed out in the study’s press release. “And now we know why,” she said.

 

 

 

 

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Weakened Knees a Big Cause of Falls for Older People: Study

THURSDAY, Feb. 11, 2016 (HealthDay News) — A new study supports what many American seniors may already know: that knee “instability” boosts their odds for a dangerous fall.

“Falls, injury from falls and poor balance confidence are extremely common and debilitating problems in older people,” said study author Michael Nevitt, a professor of epidemiology and biostatistics at the University of California, San Francisco.

“The present study has demonstrated for the first time that knee instability and knee buckling are important causes of these problems in the very large segment of the older population suffering from knee pain,” Nevitt added.

Therefore, doctors should make treating knee instability a priority among older patients, the researchers said.

Often triggered by weak muscles and poor balance, knee buckling is common among older people and those with knee osteoarthritis, the researchers explained. Along with sustaining serious injuries from falls, older people may develop fears about losing their balance and falling again.

The scientists examined the association between knee buckling among older people and their health and quality of life. The study involved more than 1,800 people whose average age was 67 when the study began. The participants either had knee osteoarthritis or were at high risk for the condition.

Knee buckling affected almost 17 percent of them at the end of five years. After seven years, 14 percent had recurrent falls, the study published Feb. 8 in Arthritis Care & Research found.

The researchers noted those whose knees “gave out” after five years were more than twice as likely to experience repeated falls, fear of falling and concerns about their balance two years later.

The participants who fell when their knee buckled at the beginning of the study were more than four times as likely to have experienced repeated falls in the next two years. They were also twice as likely to be seriously hurt in a fall. Their risk tripled for fall-related injuries that limit activities, and they were four times more likely to have balance issues, the researchers said.

“Fortunately, it may be possible to treat knee instability and prevent knee buckling with targeted exercises. Joint replacement surgery can also improve knee stability,” Nevitt said.

The researchers said doctors should talk to patients with knee osteoarthritis about their balance and whether their knees buckle.

These patients should then be counseled on protecting themselves from falls, including how to use walking aids, strengthen their legs and choose supportive shoes, they added.

More information

The U.S. National Institutes of Health provides more information on older people and falls.

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Impotence Not an Inevitable Part of Aging

THURSDAY, Feb. 11, 2016 (HealthDay News) — While the risk of impotence — erectile dysfunction — increases with age, men should know it’s not an inevitable part of growing older, experts say.

About 30 million American men have erectile dysfunction. Worldwide, the number is expected to reach 320 million by 2025, researchers have estimated.

The problem affects 22 percent of men older than 60, and 30 percent of men older than 70. But the condition is most likely due to an underlying physical or mental health condition rather than older age, according to doctors from Texas A&M University in College Station.

Heart disease and other serious medical conditions — such as diabetes, kidney disease, multiple sclerosis and Parkinson’s disease — can cause erectile dysfunction, the experts explained.

Certain medications, including antidepressants, antihistamines and blood pressure drugs, can also cause erectile dysfunction. These medications can affect nerves, blood circulation or hormones. If you suspect that’s the case, talk to your doctor, the experts said.

Another potential cause of erectile dysfunction is emotional distress caused by relationship problems, depression, anxiety, low self-esteem, guilt and fear of sexual failure.

Unhealthy lifestyle habits — such as being overweight, smoking and excess drinking, and drug abuse — can also lead to erectile dysfunction. Eating foods high in flavonoids, such as blueberries, may reduce the risk of impotence, the experts noted in a university news release.

In addition, injuries to the lower body may also cause erectile dysfunction. So while exercise is healthy, men should be cautious about any activity that may put their lower body at risk for injury. However, despite concerns that cycling may contribute to erectile dysfunction, the experts said recent research has found this isn’t true.

More information

The American Academy of Family Physicians has more on erectile dysfunction.

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Study Counters Stereotypes About Native Americans and Alcohol

THURSDAY, Feb. 11, 2016 (HealthDay News) — A new study dispels the widely held belief that Native Americans have high rates of alcohol abuse.

Native Americans are more likely to avoid alcohol than whites, and both groups have similar rates of heavy and binge drinking, University of Arizona researchers found.

The study authors analyzed responses from more than 4,000 Native Americans and 170,000 white Americans who took part in a federal government survey between 2009 and 2013.

Sixty percent of Native Americans said they drank no alcohol in the past month, compared with 43 percent of whites. In both groups, 17 percent were binge drinkers and 8 percent were heavy drinkers.

Binge drinking was defined as having five or more drinks at one sitting on one to four days in the past month. Heavy drinking was having five or more drinks on five or more days in the past month, the study noted.

The study was published online recently in the journal Drug and Alcohol Dependence.

“Of course, debunking a stereotype doesn’t mean that alcohol problems don’t exist. All major U.S. racial and ethnic groups face problems due to alcohol abuse, and alcohol use within those groups can vary with geographic location, age and gender,” lead author James Cunningham said in a university news release.

“But falsely stereotyping a group regarding alcohol can have its own unique consequences,” said Cunningham, a social epidemiologist with the university’s department of family and community medicine and its Native American Research and Training Center.

“For example,” he explained, “some employers might be reluctant to hire individuals from a group that has been stereotyped regarding alcohol. Patients from such a group, possibly wanting to avoid embarrassment, may be reluctant to discuss alcohol-related problems with their doctors.”

Study co-author Teshia Solomon, director of the center, pointed out that while alcohol use among Native Americans is comparable to that of whites, that doesn’t mean they have similar rates of alcohol-related health problems.

“Native Americans as a group have less access to medical care, safe housing and quality food, which can amplify health problems connected to alcohol,” she said.

In addition, study co-author Dr. Myra Muramoto, head of family and community medicine, said that negative stereotyping of people who have less access to care creates even more health disparities.

“Based on a false negative stereotype, some health care providers may inaccurately attribute a presenting health problem to alcohol use and fail to appropriately diagnose and treat the problem,” Muramoto said in the news release.

More information

The U.S. National Library of Medicine has more about Native American health.

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Neanderthal DNA May Play Role in Modern Human Health

THURSDAY, Feb. 11, 2016 (HealthDay News) — Neanderthal DNA has a subtle but significant impact on modern human health, including nicotine addiction, depression and blood clotting, a new study suggests.

It’s been known since 2010 that between 1 percent and 4 percent of DNA in people with Eurasian ancestry is from Neanderthals. But the impact of that genetic inheritance has been unclear.

To learn more, researchers compared Neanderthal DNA in the genetic material of 28,000 adults of European ancestry with their health records.

“We discovered associations between Neanderthal DNA and a wide range of traits, including immunological, dermatological, neurological, psychiatric and reproductive diseases,” study senior author John Capra said in a Vanderbilt University news release. Capra is an evolutionary geneticist and assistant professor of biological sciences at Vanderbilt.

The researchers confirmed that Neanderthal DNA can help protect the skin from the sun’s ultraviolet radiation and harmful germs, and they made several new findings. For example, one snippet of Neanderthal DNA can dramatically increase one’s risk for nicotine addiction. Some snippets affect risk for depression, and a number of them were linked to psychiatric and neurological effects, the study authors said.

The investigators also said they found that one snippet of Neanderthal DNA can increase blood clotting, which increases the risk for stroke, pulmonary embolism (a clot that travels to the lung) and pregnancy complications.

However, the associations seen in the study do not prove cause-and-effect relationships.

The study was published Feb. 12 in the journal Science.

The Neanderthals, humanity’s closest extinct human relative, lived about 400,000 to 40,000 years ago in Europe and southwestern to central Asia, according to the Smithsonian Institution.

More information

The University of Utah has more about genetics.

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Varied Diets May Not Curb Childhood Obesity, Study Suggests

By Kathleen Doheny
HealthDay Reporter

THURSDAY, Feb. 11, 2016 (HealthDay News) — Eating a greater variety of healthy foods may reduce the odds of being overweight in adults. But, a surprising new study suggests that a greater diversity of foods might not have the same effect in very young, poorer children, and may even increase their risk of becoming overweight.

“We found that among low-income, preschool-age children in the U.S., dietary variety and diversity were not associated with [overall] body mass index,” said study author Dr. Julie Lumeng. She is an associate professor of pediatrics at the University of Michigan Medical School and School of Public Health in Ann Arbor.

However, from year-to-year, the researchers found that greater overall food variety, healthy food variety and dietary diversity were linked to greater annual increases in body mass index (BMI) in the youngsters studied.

BMI is a rough estimate of a person’s body fat based on weight and height measurements. In children, age and gender also play a role in BMI calculations. In general, the higher the BMI, the more fat someone has, according to the U.S. Centers for Disease Control and Prevention.

The researchers said the annual changes in BMI in the children studied were small, but were “notable” because they were unexpected. Lumeng and her team had thought that a greater variety of foods, particularly healthy foods, would lead to improvements in BMI scores.

Because the findings were so counterintuitive, the researchers said it’s too soon to make any dietary guideline changes based on the results. And the study was only designed to show an association between food variety and BMI, not cause-and-effect.

Lumeng and her colleagues decided to look at the effect of dietary diversity in young children because of the prevalence of obesity in children and a lack of research on the topic. Nearly 23 percent of U.S. preschoolers are overweight or obese, and that figure rises to 30 percent in low-income families, the study authors said.

The researchers evaluated 340 preschoolers, who were all 4 years old when the study began. They were also enrolled in Head Start, a federally funded program for low-income children.

The researchers weighed children and their primary caregivers. They also asked the caregivers to complete a dietary survey to get an idea of the variety and diversity of the youngsters’ diets. Variety is defined as the number of foods eaten from a predetermined list over a given time period. Diversity includes not only variety but their relative distribution in the diet, and how well people stick with recommended dietary patterns, the researchers said.

The study authors were able to get follow-up information on 264 children from the original group two years later.

The study is published in the March issue of the journal Pediatrics.

Dr. Susan Baker, professor of pediatrics at the University at Buffalo, reviewed the findings and wrote an editorial to accompany the study. She was also surprised by the study’s outcome.

Although she can’t explain why greater variety and diversity in the youngsters’ diets didn’t lead to improved BMIs, Baker did note that the study has some limitations, as many studies do.

“The major limitation was the use of self-reported food intake data,” she said. Experts know that overweight people under-report what they’ve eaten and underweight over-report, she said.

Until more research is in, Lumeng said, “It’s still important to focus on ensuring that your child has a diverse range of foods in their diet. However, if you are concerned as a parent about obesity or preventing obesity, increasing dietary variety and diversity may not be the most important thing to be doing.”

More important, in Lumeng’s view, is to think about limiting portion sizes, reducing time spent in front of the television and other screens, and avoiding sugar-sweetened beverages.

The research may actually be good news for fretful parents of picky eaters, she said. While she’s not encouraging picky eating, of course, Lumeng said parents often worry about it. “When you look at the literature, kids who eat a smaller variety [of foods] tend to be thinner, picky eaters,” she said.

More information

To learn more about obesity in children, visit U.S. Centers for Disease Control and Prevention.

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This Is the Best HIIT Workout, According to Science

Any HIIT (high-intensity interval training) session has major fat-burning benefits, but a 4×4 workout is tops for improving fitness, per a new study in Medicine and Science in Sports and Exercise.

Tackle this treadmill workout three times a week for the next six weeks to up your cardiorespiratory fitness. Not a fan of the dreadmill? Study author Fredrik Hjulstad Baekkerud says any cardio exercise that uses large muscles (think biking or even burpees) should work, too.

RELATED: 11 Exercises That Build Muscle Without Bulk

Get started with this 4×4 HIIT workout:

 

Looking for more fun ways to get fit? Here’s a 10-minute HIIT workout that you can do anywhere.

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