NSAIDS

There is an alarming laxity in the production of research, education of public and doctors, and standards of FDA approval for drugs, as well as the monitoring of safety and effectiveness of drugs. For 2 chapters of the best book on how big PHARMA has manipulated the above and much more by Doctor Marcia Angell (Harvard Professor and former editor of New England Journal of Medicine).

Todd Schurr

Much of the quackery comes from drug companies. They put profits before the truth. In the spirit of making-the-sale they provide misinformation but to doctors and the public. The VIOXX (COX-2 inhibitors) mishap is just the surface. Every less than ideal choice based on their information effects at the very minimum the purse and the health of the drug users.

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ABDUL MATI KLARWEIN (German)

THERE IS A FUNDAMENTAL CONFUSION ABOUT BLEEDING. ONE IS CAUSED BY PLATELET REDUCTION, THE OTHER BY IRRITATION TO THE GASTRO INTESTIONAL TRACK. Aspirin and other NSAIDs cause stomach bleeding by the fact that they are corrosive. Dissolve one on your tongue and you’ll taste the proof. This confusion has been promoted by drug companies which have been marketing COX-2 inhibitors. They claim that it is the platelet reduction caused by COX-1 reduction that produces GI incidents. Wrong, it is the caustic nature of those drugs that produce GI incidences—the platelet reduction would then increase the amount of bleeding. COX-1 inhibitors produce excessive bleeding that is why there ought not to be taken prior to an operation or following one. A second confusion is promoted by comparing coated products to uncoated aspirin--aspirin is also availed with a hard, protective coating.

Goodman & Gilman, 11^th Ed.(690): “Although aspirin is regarded as the standard against which other drugs should be compared for treatment of rheumatoid arthritis, many clinicians favor the use of other NSAIDs perceived to have better gastrointestinal tolerability, even though this perception remains unproven by convincing clinical trials.” {As I pointed out, most test use a coated NSAID compared to an uncoated aspirin, and often at lower therapeutic dose.--jk}