Insufficient warning dangerous drugs by Health Canada

Despite evidence indicating seniors are being prescribed potentially dangerous drugs, Health Canada says it can't do anything more to make its warnings about these medications more effective.

The department is responding to an investigation in December revealing that doctors continue to prescribe anti-psychotic drugs to seniors, despite Health Canada warnings in 2005 that the drugs increased the risk of heart attack, stroke and death.

The analyzed sales data for the drugs indicated that prescriptions increased from seven to 40 percent for a 24-month period after the warnings.

Dr. Marc Berthiaume, director of the Marketed Pharmaceuticals Division at Health Canada, said the department warns doctors and their patients about dangerous drugs through an increasing number of safety alerts such as letters, e-mails and its website.

"We have developed over the years different ways to increase our outreach of that safety information," he said.

But he acknowledges it is up to physicians to read the mailed material. "We cannot open the letter for them. We cannot make them read them."

He said that's because the department doesn't have the legal power to do anything more than publish warnings.

Terence Young, whose 15-year-old daughter Vanessa died seven years ago after taking the drug Prepulsid, said that is nonsense. "Health Canada claims their responsibility stops when the information gets into doctors' hands. I find that disingenuous on several levels.

"The safety warnings sent out to doctors simply don't work, and this was well established at the inquest into Vanessa's death."

Young said Health Canada is wrong to claim it has no legal authority to beef up health warnings, because the law makes it clear the minister's ultimate duty is to protect the safety of Canadians.

Michèle Brill-Edwards, a pediatrician and clinical pharmacologist and one of Health Canada's fiercest critics, agrees. "The minister has in the enabling legislation called the National Department of Health Act very broad powers for the protection of the public."

"I think Dr. Berthiaume is voicing the standard views of the department that seek to limit the department's responsibility for safety."

Although Health Canada refers to its drug alerts as risk communication, Brill-Edwards said that it's hard to call it communication when no one seems to be paying attention.

Source: CBC News

Related article:

Dangerous drugs still prescribed to seniors

Violence in hospitals gets out of hand

Violence seems a part of life for those working on the front lines of this country's health care system.

The impact of workplace violence on the health care industry is enormous, exacting a heavy financial toll, according to a 2006 survey by the Workers' Compensation Board of British Columbia.

Facts in figures concerning violence against health care workers:

Injury claims

Nine percent of all B.C. health care workers' accepted claims are due to violence.

More than half of the accepted B.C. claims for health care workers are from nurses aides and licensed practical nurses.

One in five of the accepted B.C. claims for healthcare workers, due to violence in the workplace, is from registered nurses.

$24-million was spent from 2002 to 2006 in workers compensation claims involving violence against health-care workers, including physicians, nurses, care aides, pharmacists, housekeeping staff, technicians and administration.

162,934 days were lost in 2006 due to accepted claims of violence against health care workers in B.C.

Fourteen B.C. health workers were injured every week in 2006, as recorded in accepted violence claims.

Most often hurt workers' body parts in attacks

Arms, including wrists, fingers and elbows: 27 percent

Backs and shoulders: 25 percent

Head, including neck, face, eyes, ears and scalp: 14 percent

Violence against nurses in Canada:

A national survey of nearly 19,000 nurses done by the Canadian Institute for Health Information, Health Canada and Statistics Canada in 2005 found the following:

29.6 Percent of nurses working in hospital said they were physically assaulted by a patient over the past 12 months

49.6 Percent of nurses who worked in a long-term care facility, such as a nursing home, said they were physically assaulted by a patient over the past 12 months

43.6 Percent of male nurses have faced physical assaults, be they in hospital, nursing homes, a community health centre or other health care settings

27.9 Percent of female nurses have faced physical assaults in the same settings

46.3 Percent of nurses working in a hospital said they were emotionally abused by a patient over the past 12 months

48 Percent of nurses working in long-term care facilities, such as nursing homes, said they were emotionally abused by a patient in the past 12 months

54.3 Percent of male nurses have reported suffering emotional abuse over the past 12 months, be it in a hospital, nursing home, a community health centre or other health-care related settings

43 Percent of female nurses have reported suffering emotional abuse in the same settings

46.7 Percent of nurses under 35 reported they have been emotionally abused by a patient in the past 12 months

38.2 Percent of nurses over 55 reported they have been emotionally abused by a patient in the past 12 months

Groundbreaking national health survey starting soon

In the next few days, a groundbreaking national health survey is planned to be starting in British Columbia.

The survey is initiated to discover what kinds of toxic chemicals are present in Canadians' bodies, as well as examining other health issues such as obesity and disease other diseases.
Nearly 700 residents in the province will be surveyed.

By the end of 2008, more than 5,000 Canadians between the ages of 6 and 79 will have been tested.
Participants must agree to a series of physical exams, fitness testing and blood and urine tests. They'll also be required to wear an activity monitor for seven days.

According to Jeanine Bustros, the director of the physical health measures division of Statistics Canada, the survey could have major significance for health policy, depending on the findings.

"This survey will allow us, for the first time, to have a benchmark," she said.

"To be able to measure: Are we getting better? Are we getting worse?, in terms of the levels of contaminants in the Canadian population."

StatsCan will put the findings together for Health Canada and Canada's Public Health Agency. The results will become the first-ever comprehensive health study that directly measures things like obesity, lung function, chronic disease and levels of toxic chemicals in the blood.

Individual health results will be , but will be provided to participants who request them, within weeks of testing.

Only Canadians who are contacted by Statistics Canada are eligible to participate.
The results of the survey are confidential and protected by privacy laws, but will be given to participants within weeks after testing on request.

Source: CBC News

Folic Acid should be used also BEFORE pregnancy

Health care professionals are urging women who could become pregnant to up their intake of folic acid.

A panel of experts from the Society of Obstetricians and Gynecologists of Canada and Toronto's Hospital for Sick Children, along with Health Canada say certain birth defects can be prevented if women who become pregnant are taking proper amounts of folic acid.
According to Health Canada, folic acid is important in the normal development of a baby's spine, brain and skull and can prevent defects such as spina bifida.

It is recommended that women take a supplement of 0.4 milligrams of folic acid daily, along with eating sufficient amounts of foods fortified with folic acid such as spinach, broccoli, corn, oranges, peas, beans and lentils.

The supplement should be taken at least three months prior to becoming pregnant and should continue to be taken through the first three months of pregnancy.

"Folic acid becomes critical near the end of the first month of pregnancy," said Heather McAvoy, public health nutritionist at the Prince Albert Parkland Health Region

"Often women don't even realize they are pregnant at this time so it's important to have already been taking the supplement."

McAvoy also pointed out that some women are at a higher risk of having a baby with a birth defect.

"If you have had neural tube defect pregnancy, or have a family history of that problem, or if you have diabetes, epilepsy or you are overweight, you should consult a doctor before planning a pregnancy,"

Source: P.A. Daily Herald

House dust greater health risk for kids than lead paint

Canadians may be exposed to a wide variety of metals, chemicals and pesticides on a daily basis as the result of a seemingly harmless domestic nuisance: house dust.

It's a potential health hazard that scientists are only beginning to understand.
Health Canada and the Public Health Agency of Canada have embarked on a landmark four-year national study to determine levels of metals and chemicals in house dust across the country, and how health risks should be addressed.

Dust typically contains a variety of toxins released by common household products including plastics, electronics, furniture, garden soil and lead paint, which is common in older homes.

Scientists don't know for sure where all the toxins commonly found in dust come from.
They also don't know the typical concentration of metals and other toxins in house dust.

Unlike lead paint on toys or chemicals in plastic, scientists say house dust presents a far greater, unique risk because the loose, free particles can be easily ingested by children crawling on the floor or may be inhaled when dust becomes airborne.

Research has linked lead, flame retardants and pesticides found in house dust with the accumulation of these toxins in children's bodies.

"We've found high levels of lead in house dust is associated with higher blood lead levels in kids," said Paul Lioy, director of the exposure science division of the Environmental and Occupational Health Sciences Institute, at jointly sponsored by Rutgers University and the University of Medicine and Dentistry of New Jersey.

"We don't know what typical concentrations are for metals in house dust and other substances," said Pat Rasmussen, research scientist at Health Canada and principal investigator of the national house dust study.

Read the rest of the story here

Safety warning by Health Canada for sleep drug Alertec

Health Canada has issued a warning about serious skin and allergic reactions related to Alertec, a drug used to relieve excessive sleepiness due to narcolepsy, obstructive sleep apnea and shift-work sleep disorders.

The federal agency said patients taking Alertec (modafinil) should seek immediate medical attention if they have any of the following symptoms: skin rash, hives, sores in the mouth, blisters and skin peeling; swelling of the face, eyes, lips, tongue or throat; trouble swallowing or breathing; or a hoarse voice.

Alertec, made by Shire Canada Inc., is not approved in Canada for use in children for any condition.

The drug can cause mental problems. Depression, anxiety, hallucinations, mania and suicidal thoughts have been reported in patients using the drug, although these events were rare during controlled studies.

Health Canada says anyone experiencing such psychiatric conditions should stop taking Alertec and seek medical attention.

Those taking the drug should tell their doctor if they have any heart problems, chest pain, have had a heart attack or a history of psychiatric disorders. There have been previous but rare reports of severe life-threatening skin reactions and allergic reactions in adults and children using Alertec.

Two of the more severe forms of skin reaction are known as toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), either of which may quickly develop into a serious condition. There are no known factors that can predict the risk of occurrence or the severity of rash associated with Alertec.

Shire Canada has sent a letter to Canadian health-care professionals informing them of the new safety information.

The Canadian Press

Trans fat reduction going the right way, but more to be done

According to their latest study about trans fat reductions, Health Canada says that more needs to be done to lower the levels of trans fat, although progress is being made.

A trans fat task force recommended in 2006 that processed trans fats should be limited to no more than five percent of total fat.

The federal government then gave the food industry two years to reduce the amount of heart-clogging trans fat in their foods.

Sally Brown, CEO of the Heart and Stroke Foundation of Canada and co-chair of the national trans fat task force, says many companies have made "significant progress in reducing trans fats."

However, she adds that other companies "do not seem to be getting the message" and points to fast food restaurants as the leading culprits, Burger King in particular.

Brown says that Burger King has "unacceptably high levels of trans fat in many of their products" and this makes her wonder if they care about their customers.

Canadian Press and Marketwire

Drug industry used too much as source for Doctors' prescription

Following my earlier article of today about drug use among seniors:

Dr. John Haggie, a Canadian Medical Association board member who chairs its ad hoc working group on pharmaceutical issues, said government warnings often get lost in the stack of documents physicians routinely receive.

Haggie warns that there is a lack of impartial information available to doctors.

"Most of the information the physician would receive in the general course of a week on medication by and large tends to come from material from drug companies," he said.

Drug companies have a very active sales and marketing team, he said, and they follow Health Canada warnings by issuing their own.

Health Canada warnings are sent out to physicians by fax, e-mail and mail, but are often one among many documents received.

Haggie said the CMA is trying to work with the academic community to provide doctors with unbiased education material to replace documents received from drug companies.

The association is also trying to get tools on its website so doctors can quickly access the latest peer-reviewed information on what drugs are safe and which need to be used with caution.

Source: CBC

Related article:

Dangerous drugs still prescribed to seniors

editor's opinion:

"Just as I thought...............the power of marketing"

11th Case of Mad Cow Disease confirmed in Alberta

Yesterday, Canada confirmed a new case of mad cow disease (also called BSE), the country's 11th case since the disease was first discovered there in 2003.

The Canadian Food Inspection Agency said no part of the cow's carcass entered the human food or animal feed chains and is therefore no threat to the public health.

The animal was identified as a 13-year-old cow from Alberta by the national monitoring program, which targets cattle most at risk for the disease also known as bovine spongiform encephalopathy and has tested about 190,000 animals since 2003.

The animal, from an unidentified farm, was born before the implementation of Canada's feed ban in 1997.

They expect to detect a small number of cases over the next 10 years as Canada progresses toward its goal of eliminating the disease from the national cattle herd.

"This detection confirms the ongoing high level of commitment and stewardship on the part of Canadian cattle producers to food safety and animal health," the CFIA said in a statement, saying it did not expect the latest discovery to affect Canada's international standing as a country with a controlled risk for BSE.

Eating meat products with infected tissue is linked to a rare, fatal illness, variant Creutzfeldt-Jacob disease, that has killed more than 150 people worldwide, most of them in Britain.

The Associated Press

Editor:

"The government states that the 11th case was reported last May 2nd, which means the latest one is the 12th case!"

Dangerous drugs still prescribed to seniors

Doctors are still prescribing dangerous drugs to seniors, despite government warnings.

Over two years ago was reported, that more than a million seniors were prescribed atypical antipsychotics. Atypical antipsychotics are specific kinds of antipsychotic drugs. They are considered by many experts to be ineffective or even dangerous for elderly patients.

Health Canada followed up with warnings pointing to the drugs' side effects according to 13 scientific studies, which included a 60 percent greater risk of death in seniors who were taking the drugs than in patients taking placebos.
It also warned that elderly patients taking atypical antipsychotics were almost twice as likely to die from side effects such as heart failure.

In its advisory, Health Canada requested that the drugs' manufacturers include a warning describing the risk in the safety information sheet provided along with the drugs, and that health care providers refrain from relying too much on the drugs to treat dementia.

Atypical antipsychotics are drugs such as Risperidone (Risperdal), Quetiapine (Seroquel), Olanzapine (Zyprexa) and Clozapine (Clozaril).
Many of these types of drugs have never been tested on seniors.
They are intended to treat severe mood disorders, symptoms of schizophrenia and bipolar disorder in adults under 65.

A new investigation has revealed that the number of prescriptions of these drugs for seniors actually increased in spite of and after the Health Canada warnings.
They shot up in six provinces, including in Ontario and Quebec.

In some cases, they increased by 40 percent, according to sales data provided by IMS Health, a business intelligence and strategic pharmaceutical and health-care consulting firm.

Read the rest of CBC's story here

Editor's opinion:

"Hmm, I wonder if the drug industry with its incentive programs has anything to do with it..................."

In Newfoundland and Labrador an initiative for drug use among seniors has just been announced last week:

New program to help seniors taking medication in a safer way

Chalk River restarting isotope production

The nuclear reactor whose shutdown created a critical shortage of radioactive isotopes used to diagnose and treat cancer patients in Canada, the U.S. and many other nations, will resume its operation shortly.

Atomic Energy of Canada Ltd. said yesterday that it expected to begin producing the medical isotopes within seven or eight days.

The announcement came a day after the government scrambled to pass legislation allowing the company to bypass Canada's nuclear safety watchdog and immediately restart the 50-year-old reactor at Chalk River, Ontario.

The reactor was shut down Nov. 18 for maintenance and was scheduled resume operation Nov. 23.
But the Canadian Nuclear Safety Commission ordered an indefinite stoppage after discovering the reactor had been running for a year without the emergency power system being connected to two cooling pumps.

Prime Minister Stephen Harper said there was no risk of a meltdown with the startup. Company executives proposed an interim fix, in which one pump will be hooked up to the emergency power supply.

The reactor produces a radioactive substance called molybdenum-99, which is processed and packaged into canisters that are sold to big hospitals and specialized pharmacies.

The cylinders, in turn, are "milked" for technetium-99, which is used on patients. Technetium-99 is injected into patients undergoing body scans to assess a wide variety of conditions, including cancer, heart disease and bone or kidney illnesses.

Health Minister Tony Clement said he couldn't believe the AECL didn't inform health officials about the extended shutdown.

"I think it's shocking quite frankly," Clement told reporters yesterday. "... If there is an issue of extended shutdown in the future, Health Canada has to be notified immediately."

Source: The Associated Press

Related articles:

Decision made by the Commons: Chalk River "open for the public"

Isotopes Chalk river: production could start very soon

Breaking news: federal government to legislate temporary production of radio isotope at Chalk River

St. Joseph's Health Care to receive scarce medical isotope today

AECL blunder choked supply of key isotope

Ontario reactor shutdown forces cancellation of cancer tests worldwide

5 Albertans ill after mumps shot: Health Canada halts use vaccine

Today, Canada suspended use of three batches of a mumps vaccine after five people fell ill in the midst of a vaccination campaign in the western province of Alberta.

Health Canada advised against the use of the three lots of measles, mumps and rubella vaccine sold by MerckFrosst Canada, while it investigates five suspected cases of anaphylaxis, a potentially life-threatening allergic reaction characterized by swelling and difficulty breathing.

All five cases involved adults aged 20 to 30 in Alberta who had a previous history of allergy. All have fully recovered.

Canadian officials are now trying to determine if the vaccine may be having the same adverse reaction elsewhere

A joint investigation by Health Canada, the Public Health Agency of Canada and Health Alberta is being carried out in conjunction with distributor MerckFrosst Canada. It is soliciting reports of adverse effects from other countries that use the measles, mumps and rubella vaccine MMR-II.

Parent Merck & Co Inc markets the vaccine in the European Union, Australia, Hong Kong, China, Argentina, Russia, the United States, and elsewhere.

"Because all of our vaccine producers now are all global, then we also reach out globally to determine whether or not there are any other adverse events or clusters of adverse events that people are seeing elsewhere related to this product, or related to any of these lots that may be gone elsewhere," said Dr. Arlene King, a director with the Public Health Agency.

King said Canadian officials would also be contacting regulatory authorities in other countries.

Read the full story at the Reuters website.

Smoking costs more than only your health!

A new survey suggest that smokers in British Columbia could save between $2,000 and $4,000 a year by quitting and that is only the half of it.

Smokers, their family and friends, who would be spared the perils of their secondhand smoke would all have a dramatically improved health outlook and lower life insurance premiums,

In addition, Dr Fred Bass, an expert in smoking cessation and consultant to the Health Heart Society of British Columbia, found that smokers and their cohorts across Canada could save the health care system more than one billion dollars a year.

He added, "About seven per cent of our total health care bill is attributable to smoking, and those costs are not just in the last years of a smoker's life.
Research shows that smoking also interferes with recovery from surgery and those who stop just two months before surgery face fewer pulmonary and cardiovascular complications and spend fewer days in intensive care."

There's no doubt that smokers themselves are most aware of the impact that smoking has on their wallets. What many smokers may not realize is how much it adds up to in the long term. The average 45-year-old smoker, who quits today and puts the money into savings, could have more than 100,000 dollars to spend during retirement while they enjoy their smoke free health, according to a survey commissioned by Pfizer Canada, a pharmaceutical company.

Almost five million Canadians, or 19 percent of the population, are smokers. According to Health Canada, close to half of smokers will die from smoking before they turn 70 years old.

British Columbia has the lowest smoking rates in Canada at 16.4 per cent, Bass said, although it jumps from a teenage rate of 12.4 per cent to 24 per cent between the ages of 20 to 25 when young people have money, are out of school, and are targeted by tobacco marketing.

ASH

New program to help seniors taking medication in a safer way

In Newfoundland and Labrador, a new program designed to ensure senior citizens are safely taking their medications will be introduced to the Corner Brook area early in the new year.

The program will be led by Elaine Fost and Bernice Buckle, who both recently participated in a facilitators' course called Safe Medicine for Seniors.

The course, designed by Health Canada, was offered at the Victorian Order of Nurses national headquarters in Halifax.

Fost and Buckle plan to deliver presentations to seniors and caregivers, teaching them tips on mixing combinations of prescribed and over-the-counter medications, safely storing and discarding medications and preparing for visits with doctors and pharmacies.

The Western Star

GlaxoSmithKline Inc. prescribes restricted use of diabetes drug Avandia

GlaxoSmithKline Inc., the manufacturer of a drug for treating Type 2 diabetes has placed new restrictions on use of the medication based on a Health Canada review of clinical data pointing to an increased risk of heart-related problems in some patients.

In consultation with Health Canada, Glaxo is updating prescribing information on products made from or containing the drug rosiglitazone: Avandia, Avandamet and AvandarylTM.

Once touted as the gold standard for preventing Type 2 diabetes in high-risk patients, rosiglitazone lost its glitter after a study published in the New England Journal of Medicine in May showed Avandia significantly raised the risk of heart attack and possible death.

The NEJM analysis of 42 studies revealed a 43 percent higher risk of heart attack for those taking rosiglitazone compared to people taking other diabetes drugs or no diabetes medication at all.

Glaxo said patients taking rosiglitazone and especially those with underlying heart disease or with a high risk of heart attack or heart failure should talk to their doctor about the benefits and risks of continuing the drug.

Important restrictions for patients are:

• Rosiglitazone should not be used in patients with any stage of heart failure
  
• Rosiglitazone should not be taken if insulin is also being used.
• Rosiglitazone should not be used as part of a "triple therapy" in combination with metformin and a sulfonylurea drug.

Rosiglitazone can cause the body to retain fluid, which can worsen some heart problems and lead to heart failure, swelling and weight gain.

Several lawsuits have been launched in Canada and the United States over the medication's adverse effects, and drug safety regulators in both countries have been investigating its safety.

CBC