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Disposing of Unused Medications: Have We Been Doing It All Wrong?

Most physicians probably give little thought to the estimated 10%-30% of medications that patients don’t end up consuming.1, 2 On the rare occasion when patients do ask their doctors where to dispose of unused medications, a physician could hardly be criticized for recommending disposal in the household garbage. Indeed, until recently, trash disposal was assumed by most […]

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Strong Man with a Weak Heart: The Ill Effects of Performance-Enhancing Drug Use

An undisclosed habit accounted for severe left ventricular dysfunction and hepatic lesions in a young bodybuilder. A 25-year-old bodybuilder with a history of liver cysts presented with a 5-day history of epigastric discomfort, nausea, vomiting, diaphoresis, and intermittent shortness of breath. The patient was not taking any prescription medications and denied use of tobacco, alcohol, […]

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Curious Crosses: Injection-Induced Lesions

Skin biopsy provided an elusive diagnosis and evidence that the patient had likely omitted important information during medical interviews. A 43-year-old man with a history of alcohol and opioid use was admitted to the inpatient ward from the infectious disease clinic. For 2 weeks, he had experienced recurrent, painful skin nodules that expressed bloody, purulent […]

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The Tragedy of the Commons – Drug Shortages and Our Patients’ Health

  There has been, rightfully, a great deal of controversy related to the EpiPen pricing issue1; a preparation sold for $83 by Merck (Rockville, Md) a decade ago is now priced at $600. The fury directed at the company now marketing this drug-delivery device – Mylan (Canonsburg, Pa) – came from patients, families, and legislators; […]

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Joseph S. Alpert

A Sticky Problem: Dealing with Industry Under Unpleasant Circumstances

  In this issue of the American Journal of Medicine, Dr Leonard Fromer appropriately calls for easier access to potential lifesaving therapy, the epinephrine auto injector, for patients with severe allergic reactions. The editor and the staff of the AJM strongly support the concept that epinephrine auto injectors should be made affordable and easily accessible for patients who are […]

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