Medications and treatments Archive

Ask the doctor

Q. I just got a stent placed in my heart artery and feel great again. If it develops problems, can it be treated?

A. Stents, the tiny wire-mesh tubes used to prop open blocked arteries, are useful for treating heart attacks and chest pain that occurs with physical activity. They're placed during a coronary angioplasty and stenting procedure, which usually involves snaking a thin tube (catheter) through a vessel in the upper thigh or the wrist up to the heart. After more than two decades of use, today's stents are safer and more effective that the original versions. Problems can still arise, but they are uncommon and treatable.

These wrist-worn devices are better than ever at gathering data. But it's still too early to use them to screen for atrial fibrillation.

The original wristband monitors were pretty basic: they tracked your movement and tallied your daily steps. But before long, these digital devices could also estimate your heart rate, thanks to a sensor that measures changes in blood flow through your skin. Now, there are smartwatches with special sensors that can record a tracing of your heart's electrical signature (electrocardiogram or ECG) and alert you if it detects an irregular rhythm.

Last fall, the FDA granted Apple approval for the ECG sensor and an app that includes an algorithm to detect atrial fibrillation, or afib, the most common heart rhythm disorder (see "What is atrial fibrillation?"). While the Apple Watch Series 4 is the first of its kind to offer this feature, other companies have similar technologies in the works.

Here's how to prepare for the coming allergy season.

Spring is in the air, and so are millions of pollen particles, the tiny grains that fertilize plants. Seasonal allergies — also known as hay fever — can affect almost anyone and at any time in life. Although most people begin to experience allergies in childhood or early adulthood, sometimes the symptoms become more problematic later in life, especially if their living environment changes.

"Even if you have never suffered from allergies — or used to when you were much younger but not anymore — there is a good chance you will become more sensitive to pollen as you reach your 60s and 70s, although it's not clear why," says Dr. Mariana Castells, of the Department of Allergy, Rheumatology, and Immunology at Harvard-affiliated Brigham and Women's Hospital.

In the journals

People who have had a heart attack or a stroke are routinely prescribed a statin to reduce the risk of a repeat event. But by also following a Mediterranean-style diet, they can improve their chance of living longer, suggests a study in the Feb. 1, 2019, issue of the International Journal of Cardiology.

The study looked at 1,180 people, average age 68, who had at least one previous heart attack or stroke, and recorded their statin use and diet intake at the study's beginning. The researchers identified the people who faithfully followed a Mediterranean-style diet. A Mediterranean-style diet involves consuming medium to high amounts of whole fruits and vegetables, whole grains, legumes and nuts, olive oil, and poultry and fish, with limited amounts of red meat, alcohol, and dairy.

But these remedies aren't the best choice if you have frequent heartburn.

You feel the familiar sensation in your chest: heartburn. Again, you find yourself reaching for the bottle of antacids in the medicine cabinet. It's something you've done a few times a week for the past six months. Is it okay to keep popping over-the-counter acid reducers, or is it time to see a doctor?

We asked two experts, Dr. Jennifer Nayor and Dr. Molly Linn Perencevich, both instructors in medicine at Harvard Medical School, for their thoughts on heartburn, including when it's okay to use over-the-counter antacids and when you should seek other treatments. Below are their responses.

Medications can be lifesaving by performing critical tasks such as keeping blood sugar at safe levels, hearts thumping rhythmically, and moods afloat. Yet side effects and interactions between drugs (both prescription and nonprescription drugs) may increase your fall risk in numerous ways. Prime examples include blurred vision, dizziness or lightheadedness stemming from low blood pressure, drowsiness, delirium, and impaired alertness or judgment. Some medications may affect the inner ear, spurring temporary or permanent balance disorders.

Often, problems stem from the sheer number of medicines you take, rather than a single drug. According to a national health survey, a third of 45- to 64-year-olds and two-thirds of people 65 and older take three or more prescription drugs over the course of a month. And 16% of 45- to 64-year-olds, as well as 39% of people 65 and over, take five or more drugs. Some gerontologists say they rarely see patients who take fewer than six or seven. Taking many medications at the same time can boost the severity and frequency of side effects among people of any age. Older adults are especially vulnerable, because people's bodies absorb and respond to drugs differently with age.

News briefs

Three newly approved medications are garnering national attention. The first is an oral form of a powerful opioid painkiller that's been available by injection since 1984. Dsuvia is the sublingual (under the tongue) version of sufentanil, and it was approved by the FDA in November 2018. Dsuvia is 1,000 times more potent than morphine. The FDA says it may be helpful for use on the battlefield or in hospitals. Critics worry the drug will wind up on the streets, furthering the country's opioid crisis. Another medication of note is the first prescription drug made from marijuana. The FDA approved cannabidiol (Epidiolex) in June 2018 for the treatment of seizures associated with rare forms of epilepsy. The medication is made from a component of marijuana that does not cause intoxication or euphoria. And finally, baloxavir marboxil (Xofluza), the first new antiviral in 20 years to help fight the flu, received FDA clearance in October 2018. The drug is a one-dose pill that may help shorten the duration of the flu if it's taken within 48 hours of the start of symptoms. One caution: the new antiviral has not yet been tested in older adults, so talk to your doctor if the drug is prescribed and you have concerns.

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