Drugs (Sometimes) Work

Craig Williams
  • 5.0 (3)
  • MEDICINE

An exploration of the science and the data behind many commonly used prescription drugs.

  1. 05/12/2022

    Vitamania, Part 2

    In this second part of the 2-part episode "Vitamania," we dig in to the clinical trial data behind vitamins as dietary supplements. In Part 1 of this episode, we met a patient with Scurvy....and said that if you have Scurvy, Vitamin C definitely works. But what if you are generally nutritionally replete? What does the data say about the role of vitamins as dietary supplements in the > 99% of people who do NOT have any diseases of vitamin deficiency? And how much clinical trial data is there? And are the outcomes different for people with diabetes or established cardiovascular disease? We'll address all these questions....and then conclude by briefly addressing how commercial vitamins are made and why that accounts for the most common adverse effects that we see with vitamins.

    22 min

  2. 05/10/2022

    Vitamania, Part 1

    Vitamins are widely used in the U.S., to the tune of between $15-20 billion dollars per year. But what are vitamins and what do they do? How are they regulated by the FDA and does the clinical trial data on vitamin supplementation justify our consumer appetite for them? Over this two part episode we'll discuss all of that. The goal, as always is to simply inform so that we can all make up our own minds about the role that vitamins might play in our general good health.

    16 min

  3. 06/02/2021

    Drugs (Sometimes) Work: "Do ACE inhibitors treat Diabetes?"

    Before we ask a patient to take any drug we should be confident that the benefits outweigh the risks. This involves considerations like duration of therapy and whether the drug is being used to treat a disease versus prevent it. But even more important is an understanding of how the pharmacology of the drug matches up to the pathophysiology of the disease. The better we understand both, the better we'll be at deciding when to use any drug for any disease. In todays episode we apply these tenets of drug therapy to a common question, "does my patient with diabetes need to be on an ACEi or ARB?" To answer that question, we'll discuss the merits of drugs for disease prevention versus disease treatment. The use of risk factors for disease may or may not be sufficient to justify drug therapy. An LDL cholesterol of 220 is sufficient to initiate cholesterol lowering therapy. But is diabetes a sufficient reason to initiate an ACEi or ARB? We'll figure that out....and whether or not the answer surprises you, we'll learn things along the way that will be useful in virtually all settings of applied pharmacotherapy.

    17 min

  4. 05/18/2021

    Medicating the Failing Heart, Part 3 of 3: The finale

    As we finish up we focus on the contemporary management of systolic heart failure or so called heart failure with reduced ejection fraction. Our focus in this episode is on RAAS blockade which includes the aldosterone antagonists along with a new kid on the block, Entresto. How does Entresto compare and where does it fit in to our contemporary management of systolic heart failure? We'll discuss that, along with the reason why we dont see much Digoxin anymore. When we're done, we'll have a very complete contemporary approach to how best to use pharmacotherapy in our patients with heart failure.

    23 min

  5. 05/12/2021

    Medicating the Failing Heart; Part 2: The difference between a drug and not a drug is dose

    In this continuation of "Medicating the Failing Heart" we pick up the theme of systolic heart failure and how good beta blockers are or aren't compared to our newest agent for systolic heart failure - vericiguat. As we discuss, beta blockers hold their own quite well. But beware. Having a patient on a beta blocker is not the same thing as having them appropriately medically beta blocked. We'll discuss what that means and explain that while it's been said that the difference between a drug and a poison is dose, it is also true that dose determines when something is a drug at all.

    17 min

  6. 05/07/2021

    Episode 9, Medicating the failing heart, Part 1

    When it comes to treating symptomatic heart failure, many things have changed but many have not. Some things that haven't changed maybe should change - that depends on who you listen to. In this multi-part episode, we'll discuss the past and present of drug therapy for both common types of heart failure. By the end, you'll know a bit of history, you'll know a lot about how well different drugs work for heart failure and you'll even know where the American College of Cardiology held one of it's annual meetings in the early 2000's.

    14 min

  7. 04/23/2021

    "Ceph-a-Something" Part 2: pesky PK

    The cephalosporin antibiotics are a confusing class of medications. We talk about them in "generations" like a pharmacologic family tree. And while there is a general rule regarding which bugs are covered by the different generations, the exceptions to that rule are numerous and just as important as the rule itself. In this 2-part episode, we'll unpack the cephalosporins a bit. We'll explain what it means for one agent to be "better" than another at treating a particular bacteria and why the 4th and 5th generations only have one drug each. In the end, we wont be infectious disease experts but you also wont have to call them the "Ceph-a-somethings" ever again.

    15 min

  8. 04/23/2021

    "Ceph-a-Something" Part 1: Genealogy

    The cephalosporin antibiotics are a confusing class of medications. We talk about them in "generations" like a pharmacologic family tree. And while there is a general rule regarding which bugs are covered by the different generations, the exceptions to that rule are numerous and just as important as the rule itself. In this 2-part episode, we'll unpack the cephalosporins a bit. We'll explain what it means for one agent to be "better" than another at treating a particular bacteria and why the 4th and 5th generations only have one drug each. In the end, we wont be infectious disease experts but you also wont have to call them the "Ceph-a-somethings" ever again.

    12 min
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About

An exploration of the science and the data behind many commonly used prescription drugs.

Information

  • Creator
    Craig Williams
  • Years Active
    2021 - 2022
  • Episodes
    15
  • Rating
    Clean
  • Copyright
    © Craig Williams
  • Show Website
    Drugs (Sometimes) Work