Can aspirin cause macular degeneration?

Posted March 21, 2013

DEAR DOCTOR K: I take a daily aspirin to prevent a heart attack. I just read that aspirin can cause macular degeneration. Should I stop taking it?

DEAR READER: No, you shouldn't stop taking aspirin. Medicine — and life — is full of trading off one risk for another. Doctors and medical scientists aren't (yet) smart enough to discover or invent treatments that have absolutely no risks, only benefits. So you have to compare the risk of a treatment against your risks if you don't take it.

Should I take tamoxifen longer than five years?

Posted March 20, 2013

DEAR DOCTOR K: I was diagnosed with ER-positive breast cancer a few years ago. My doctor told me to take tamoxifen for five years to prevent my cancer from coming back. I recently read that taking tamoxifen longer further decreases the risk of a cancer recurrence. What should I do?

DEAR READER: The simple answer is: Ask your primary care doctor if you should talk to a breast cancer specialist, because it may well be a good idea to continue on the tamoxifen. But I know you won't be satisfied with a simple answer, so here's a more elaborate one.

How does Pradaxa compare with warfarin?

Posted February 19, 2013

Woman inspecting prescription pill bottle label

DEAR DOCTOR K: My wife has atrial fibrillation. Her medication was recently changed from warfarin to Pradaxa. Her doctor says the new medicine does not require regular INR tests and is just as effective. Is that so?

DEAR READER: Yes, it is. Before I explain why, let me provide some background. In people with atrial fibrillation, the upper chambers of the heart (the atria) lose that strong beating action that keeps the blood moving efficiently. As a result, blood tends to pool in the atria. When it does, clots are more likely to form.

Can growth hormone slow the aging process?

Posted January 05, 2013

Tired Senior Man Looking At Reflection In Bathroom Mirror

DEAR DOCTOR K: I'm a 77-year-old man. I've read about the effects of growth hormone, and they sound great. Is there a downside?

DEAR READER: I've also seen the many "anti-aging" claims associated with growth hormone, and I understand their appeal. Like most people, I want to live a long time, but I don't want to grow old. But does growth hormone (GH) work? And is it safe? Those are both complicated questions to answer, but here goes.

How does atrial fibrillation increase stroke risk?

Posted January 02, 2013

Atrial fibrillation reading on heart monitor

DEAR DOCTOR K: I have atrial fibrillation. It doesn't bother me, but I still have to take medications because the condition apparently increases my risk of stroke. How does it do that?

DEAR READER: Atrial fibrillation is a heart rhythm disorder that causes a rapid and irregular heartbeat. The atria are the upper two chambers of the heart; they receive blood from the rest of the body. The atria pump blood into the lower two chambers of the heart (the ventricles). Then the ventricles pump blood to the rest of the body. During atrial fibrillation, the atria do not beat normally. Instead, they quiver or "fibrillate."

How do Alzheimer’s medications work?

Posted November 16, 2012

Alzheimer's disease symbol isolated on white background

DEAR DOCTOR K: Can you tell me about medications to treat Alzheimer's disease? How do they work, and what do they do?

DEAR READER: The drugs currently available to treat Alzheimer's disease target the symptoms, but not the underlying causes of the disease.

Can grapefruit cause dangerous drug interactions?

Posted November 10, 2012

DEAR DOCTOR K: I've heard that grapefruit can interact dangerously with some medications. Is this true?

DEAR READER: I love grapefruit and grapefruit juice, so I remember my reaction the day a colleague told me about new research showing such dangerous interactions: Bummer! Grapefruit and grapefruit juice are a great source of vitamin C, potassium, dietary fiber and other nutrients. But there's another side to the story. Grapefruit and grapefruit juice really can interact with dozens of medications -- sometimes with dangerous results.

How is heart failure treated?

Posted November 02, 2012

DEAR DOCTOR K: My father takes several medications for heart failure. Can you tell me what these drugs do?

DEAR READER: Heart failure (also called congestive heart failure) is a condition in which the heart cannot pump efficiently enough to meet the body's need for blood. Unlike a cardiac arrest, the heart is still pumping; it's just not fully doing the job.

How do anti-TNF drugs work against rheumatoid arthritis?

Posted October 31, 2012

DEAR DOCTOR K: I have rheumatoid arthritis and take anti-TNF drugs. I'd like to understand how they work.

DEAR READER: Rheumatoid arthritis (RA) is a chronic autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in the joints. Our immune systems are not supposed to attack our own tissues; they're supposed to attack foreign things that enter our body, particularly germs. In autoimmune diseases, however, something goes haywire.

Can medication help with opioid addiction?

Posted October 08, 2012

DEAR DOCTOR K: I started taking oxycodone for chronic back pain, but now I'm addicted to it. I've heard there may be medications that can help me quit.

DEAR READER: Oxycodone, like morphine, codeine and hydrocodone, is an opioid drug. Opioids are among the most powerful painkillers available. They can also produce a feeling of well-being and euphoria. Opioids affect the brain by attaching themselves to structures on brain cells called receptors. The opioid is like a key and the receptor is like a lock. When the key fits into the lock, the brain cell is affected.

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