Acetaminophen (Paracetamol, APAP): It is the most widely
sold over-the-counter drug for the relief of pain,
fever, and headaches. It
is found in
over a 100 over-the-counter and prescription preparation (mostly opiates).
As a mild analgesic APAP’s inclusion with an
opiate cannot be justified given its severe side effect of causing live
damage. The annual
percentage of potentially fatal acute liver failure (ALF) hospitalizations
caused by acetaminophen rose from 28 percent in 1998 to 51 percent in 2003. A major cause is that acetaminophen is
indicated as APAP on most opiate prescriptions and the common use of the
over-the-counter Tylenol as a second drug for relieve of pain.
In a well-designed study it was found that
39% of those taking the recommended dosage of APAP had 3 to 8 times the upper
limit for ALT a marker for liver toxicity.
APAP in 2010 caused 56,000
emergency-room visits, 26,000 hospitalizations and 1,600 liver failures,
and this is based on a system designed to grossly underestimate the severity of
the problem. New FDA limits and warning goes into effect
in 2014. A study of
205,487 children age
6-7 found that the use of APAP is associated with a 323% increase in the risk
of asthma. Four weeks
of prenatal use of
APAP is associated with lower motor, cognitive development and more behavioral
problems when compared to a sibling by over 70% for each.
Other study found that APAP during pregnancy
was associated with hyperactivity (ADHD, another with failure to develop testes
(cryptorchidism), and a third with lower masculinization development.
The medical literature on liver toxicity goes
back to the 1960s. Pharma
is very good
at controlinge information given to doctors and the public.
& Cancer: For simplicity the discussion
limited to the most common
cancers. Within them are two groups, one with an overall survival of above 50%,
colon, prostate and breast; while for small cell lung and pancreatic cancers
the 5-year survival is less than 5%. If
fatal, it is metastatic--spreads to distant tissues, and chemotherapy is not curative.
The basic question, once diagnosed, is the
factors are relevant
to estimating how invasive
cancer is. A biopsy
examined under the
microscope that reveals many highly abnormally shaped cells has a high
statistically association with aggressive (fast growing) cancer, but about 40%
are still indolent. Found
in 3 local
lymph nodes is associated with metastatic (about 60%), and aggressive (about
80%) of cancers. Distant
cancer has about a 10% chance of being indolent with about half (5%) living
past 5 years. However,
there is no way
to know at stages I through III, if that cancer has become metastatic.
If small colonies have already spread to
distant tissues, removal of the primary tumor does not change the
prognosis. The clock
however is running
as to when a cancer will change from indolent or local aggressive to a
metastatic cancer. This
through the involvement of stem cells.
The prompt removal of the cancer is the prudently choice to prevent stem
cell involvement. If
cancer remains, once discovered it can be removed; chemotherapy does not affect
the course of the disease, it just extends life 3 months.
Those few with metastatic cancer who live
several years, do so not
an atypical response, but because the cancer is indolent.
Without strong proof that the chemotherapy is
curative, it is not worth taking. Remember as stated in “Marketing
Science”: the assorted conflicts of
by the role of pharm in research, education, treatment guidelines entail that
the oncologist is a misinformed patient guide.
Also major Positive bias
is the norm: pharma
funds clinical trials, owns the
results, write it up, and publish in pharma “friendly” journals.
Cancer basics: cancer is distinguished from a
benign tumor by its ability to invade neighboring
tissue and sometimes spread to distant tissues (metastasize). Also benign tumors generally have a slower
growth rate and are more differentiated (look like normal cell ).
This is the first area where business has
blurred the distinction between benign and malignant by often calling benign
“carcinoma”; it isn’t unless there is evidence of invasion to adjacent
tissue. Critics have
pointed out the
negative consequences of treating benign tumors of the breast prostate, thyroid
cancers, and other tissues chemotherapy following excision or
in long-term trials show no benefit or worse.
Benign breast tumors, called “cancer”, when treated with chemotherapy
shorten life over 4.5 years (mostly through the use of an estrogen
drugs and the exclusion of those patents from HRT). In general treating stage I, II, & III
cancers aggressively with chemotherapy doesn’t change the course of the disease,
but shorten the life of all for who are cancer survivors.
The chemotherapy is pointless because all of
it has been removed by excision. With
the exceptions of a few tissue types, chemotherapy doesn’t cure cancer, but
rather shuts down an essential biological process that affects the rate of cell
reproduction, including in the cancer.
This toxicity limits the chemotherapy.
The average remission (slowing of growth) is 3 months. About half of the patients will have
long-term side effects. Patients
physicians believe that the chemo destroys cancer missed by excision, it
doesn’t, and they also believe that those with metastatic cancer who live pass
the average do so because of a typical response to the chemotherapy, but rather
it is because that patient had an indolent (slow growing) cancer.
Pharma’s two deception are to deny indolent
metastatic cancer, and to claim that chemotherapy can destroy for a few
patients the cancer missed by excision.
The oncologists’ greatest source of income is the spread between the
discount price they get the chemo and what they bill.
Chemotherapy is thus oversold.
The mechanism for pain reduction is through the reduction of inflammation by
50% of COX2 & COX1 enzymes and inhibiting the production of
prostaglandins (Goodman & Gilman’s pharmacology textbook 2007 edition, p.
is why they are classified as
“mild analgesics” (G & G at 681).
Other claims as to medicinal use is at best only weekly supported.
A number of different families of
drugs are clearly not worth the side effects for which we have not written a
position paper, yet we are aware of the tenuous evidence and warning issued by
others. We turn to site such as
Worstpill.org, and Cocharanereview.org act as watchdogs. But they are limited
by their sources: they rely upon the FDA and meta-analysis
(combining results of several clinical trials) of the treatments. They choose
their battle and thus repeat the
pharma generated errors on aspirin and hormones. But clinical trials are funded
by pharma and positive
32%, thus meta-analysis reflect this distortion. Our other sources are
critics of treatments
that are published in medical journal, older medical textbooks. Sometimes we
find a conflict between the
scientific analysis of the condition and the modus operandi (method of action)
of the drugs. Also many on the face of
it are suspect: giving downers to
depressed patients, treating osteoporosis with unnatural chemicals that go to
the bones rather than calcium compounds, attempting to treat a condition with a
drug that doesn’t act upon the underlying cause. A junk drug does more
harm than good, and
often there are clearly better alternatives.
Below is the current list of other junk drugs.
Junk list: Bisphosphonate
for osteoporosis. They increase
the bone density by putting a
compound containing two phosphate groups (P03) in the bones, It isn’t
the same as bone building the
natural way with hydroxyapatite (Ca10(PO4)6(OH)2)
and collagen. Bisphosphonates
don’t prevent fractures long-term and there are side effects. NSAIDs but for
aspirin. They have minimal pain reduction effect, work
well as an anti-inflammatory drug by reducing inflammation, thus their affect
upon pain is minor, as demonstrate by clinical trials. Unfortunately they increase
with long-term usage the incidents of heart
attacks and strokes—from 50% to 400%.
This includes the block buster Celebrex which increases with long-term
usage risk 200%. Psychotropic
drugs used for psychiatric conditions are much worse
than behavioral therapy and worse than no treatment. “When both published and
unpublished trials are looked at, paroxetine [Paxil] does not appear to be
any better than placebo in adults with moderate or severe depression” Wiki. With only a couple of exceptions all
drugs are tranquilizers (downers):
hinder cognitive function and cause drowsiness. Since “downer” and “tranquillizer”
negative connotations, they all wear different labels for marketing, such as
mood elevator, muscle relaxant, ACE inhibitor, SSRI, etc. Besides used for behavior
tranquilizers are widely prescribed for physical conditions such as for back
pain, angina, brain trauma, epilepsy, menopausal hot flashes, hypertension, and
so on; even though they don’t affect the core problem and benefits in pharma’s
clinical trials are only slightly better than a placebo. Tranquilizers are spotted
by the side effect
of drowsiness and their indication for psychiatric conditions. FDA approval
is based on 6-week clinical
trial of an ideal population for the goals of the trial—not a real-world
clinical population. By impairing
cognitive function, these drugs do not promote long term behavior improvements
in the general population (no more than alcoholism or marijuana does). They
do not help people deal the underlying
psychiatric behavior problem, In a 2014
population study, “After excluding
deaths in the first year, there were approximately four excess deaths linked to
drug use per 100 people followed for an average of 7.6 years after their first
prescription” BMJ. These downers by reducing cognitive function
make the patient more dependent upon expert opinion, their doctor and thereby
are associated with polypharmacy; and they shorten life. They negatively affect
quality of life, which
is why there is low compliance.
Treatment of children psychiatric disorders--before the 70’s quite
rare--is unwarranted (with rare exceptions).
Most conditions requiring hospitalization will include a tranquilizer,
protein pump inhibitors (PPI) and
acetaminophen (APAP). Sleep and
cognitive confusion reduces
discussion with staff and thus lightens the work of the care givers, plus they
increases profits. Alzheimer’s
disease (AD), drugs do not affect the course of the
disease. Factoring in the side effects,
they are worse than a placebo. Downers
are often included in treatment of AD,
as if the patient needs more cognitive impairment. Avoid for AD Aricept (donepezil), tranquilizers, & Cognex (tacrine) and
all other drugs given to purportedly slow the progress of AD (they don’t)
or make the patient more manageable. Downers that shorten life and increase
of dementia. Acid reflux condition
(heart burn) should be treated with
over-the-counter antacids; avoid the prescription alternatives, especially
protein pump inhibitors which have rebound effect if stopped which increases
heart burn. There is a lack of effective
drugs for COPD, restless-leg syndrome and many of the minor complaints that are
listed in the Merck Manual, such as fungal infection of the nails. Tamiflu and
other flu medications such as are
junk (see Bad Pharma supra 81-91). Pharma
is very good at making a drug not worth taking appear as safe and
Pharma is also very good at cooking
up new indications for drugs and having them used off label. Over half the prescriptions
given are for
uses that have not meet the very low FDA hurdle. Most off-label uses have shoddy
research (phase IV clinical trials), which are used to “educate” doctors.
In general, off-label uses are not in the patient’s
best interest. Doctors have been cast in
the role of drug pushers through clinical guidelines, clinical administrators,
peer pressure, financial rewards from pharma, a lack of reliable information on
treatment alternatives, and continuing educations class given by pharma to name
the main ones. The $600 industry is very
good at marketing.
What is good?
There are a number of very useful
drugs, some of treating conditions, others for preventing them. Once off-patent,
the norm is for pharma to do
shoddy studies to show their newer patented drugs are superior. Pharma fund
and government funded medical
studies of the last 2 decades is all about marketing—significantly more so than
earlier studies. Off-patent drugs that
prevent chronic conditions are especially singled out (as our papers on HRT and
aspirin demonstrate). Older drugs are
safer than newer drugs because with usage side effects are revealed. Supported
by doggy studies, the newer are
hyped as better. Thus without compelling
evidence, don’t take the newer patented drug when an older off-patent drug is
What clearly works
(prescriptions): Antibiotics work for
bacterial infection; antifungal preparations may be effective. The claim of
microbial tolerance is supported
by doggy studies. Opiate family of pain
medications. Local anesthetics such as
procaine and lidocaine, anti-infective medicines to deal with immune reactions
such as antihistamines and hydrocortisone,
anti-AIDS drugs, for edema diuretics, insulin for diabetes,
levothyroxine for thyroid hormone, vaccines, nitroglycerin for angina and
myocardial infarction (MI), streptokinase for MI and other thrombosis, drugs
for worm invasions, body lice, amoebic and such. Of course there are more for
situations such as anemia, genetic conditions, ear infection, and so on.
For the major health issues the
best treatment is defensive. For diet
that lowers the risk of obesity, cardiovascular disease, and metabolic syndrome
a 2 page
summation. For drugs that prevent major health
issues with compelling evidence with links (which of course pharm attacks with
their marketing studies) CoQ10, aspirin325 mg, and natural
hormone replacement therapy for women, and for elderly
men testosterone in sufficient dose. And if you are in doubt about the
corruption worked by pharma in the information system and medical practice,
please read Marketing Science. Also go to the video page for
convincing documentaries, including the YouTube link to 60 Minutes 2012 segment
on fructose, and there is a list of books.
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