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A Selection of Research Abstracts and Patient Prescription Receipts

Delineating A Drug Prescription Sequence Whereby the Use of One

Drug Causes a Condition That Creates A Demand For Yet Another Drug, which then Causes Yet Another

Condition which Requires Further Drugs; The Deleterious Effects on the

Patient [click each page to advance]

Assembled by The Widow

Table of Contents4. Statins Cause Diabetes, Creating a Demand for Metformin5. Inhibition of Cholesterol Impairs Insulin Secretion6. Thyroid Dysfunction in Patients with Diabetes7. Simvistatin Blocks Glucose Mediated Uptake; Metformin is

Prescribed.8. More Kidney Disease with Long Term Statins Prescribed;

Losartan is Prescribed9. Use of Statins Increases Calcified Plaque in Coronary Arteries,

Leading to Higher Prevalence of Coronary Artery Disease 10. Statins(HMG CoA Reductase Inhibitors) Block The Production

Of Coenzyme Q Which Is Needed For Heart Muscle Function11. Oral Supplementation of CoQ10 in Diabetic Patients Increased

Serum Coenzyme Q10 Levels Without Affecting Cholesterol Levels

12. After Heart Failure, Patient Gets Prescribed Spironolactone, Incurring a Major Adverse Interaction with Previously Prescribed Losartan Which Could Lead to Kidney Failure

13. Arterial Calcification is Common in Patients With End Stage Renal Disease

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Table of Contents (cont.)

14. Vascular Calcification in End Stage Renal Disease15. As an Additional Response to Congestive Heart Failure, Patient

Gets Prescribed Warfarin, Which Also Causes Arterial Calcification

16. Progression of Vascular Calcification Use is Increased with Statin Use in the Veterans Affairs Diabetes Trial (VADT)

17. List of Drugs Prescribed Three Months Prior to Patient’s Death18. Cephalexin and Furosemide - Drug Interaction Bad for Kidneys19. Lasix and Furosemide, Another Drug Combo Bad for Kidneys20. List of Adverse Drug Interactions21. Misdiagnoses of Arterial Calcification22. Narcotics Further Stressing Kidneys are Prescribed to Patient23. Final Hospital Stay24. Flowers on the Water

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Statins Cause Diabetes Statins slow the output of the thyroid to the pancreas.

The pancreas then slows the production of insulin, causing diabetes. Type II diabetes is first treated with

metformin. Then as the diabetes gets worse, the patient is switched to insulin.

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Simvistatin was also discovered to inhibit glucose uptake after insulin stimulation

Metformin is prescribed to reduce blood glucose and insulin resistance

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Losartan is then prescribed to slow long-term kidney damage in people with type 2 diabetes who also have high blood pressure.

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Use of Statins Increases Calcified Plaque in Coronary Arteries, Leading to Higher

Prevalence of Coronary Artery Disease

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Coenzyme Q10 is essential for all cellular ATP production and is of particular importance in heart muscle function given that tissue's extreme energy requirements. A deficiency of CoQ10 in the blood and the heart muscle has been documented in congestive heart failure (Kitamura 1984, Folkers 1985). An Australian group of cardiovascular surgeons has recently documented impairment in myocardial function secondary to age-related CoQlo deficiency in patients undergoing coronary artery bypass surgery (CABG). That impairment was completely eliminated with incubation of the atrial myocardium with CoQ10 (Rosenfeldt 1999).

It is well established that the mevalonate pathway is involved not only in the biosynthesis of cholesterol but also in the biosynthesis of the essential co-factor required for energy production, coenzyme Q1o (CoQ10, ubiquinone). As such, HMG CoA reductase inhibitors block the cellular production of cholesterol and of coenzyme Q10 (Rudney 1981, Goldstein 1990). This drug nutrient interaction has been reviewed (Bliznakov 1998, Bliznakov 2002).

Statins(HMG CoA Reductase Inhibitors) Block The Production Of Coenzyme Q Which Is Needed For

Heart Muscle Function

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In 1999, Miyake et a1 studied 97 non-insulin-dependent diabetic patients treated with simvastatin and observed a significant decrease in serum CoQ10 concentrations along with the decrease in serum cholesterol (Miyake 1999). Oral CoQ10 supplementation in diabetic patients receiving simvastatin significantly increased serum coenzyme Q 10 levels without affecting cholesterol levels. Furthermore, the supplemental coenzyme Q 10 significantly decreased cardiothoracic ratios from 51.4 +/- 5.1 to 49.2 +/- 4.7% (pC0.03). The authors concluded that serum coenzyme Q10 levels in diabetic patients are decreased by statin therapy and may be associated with subclinical diabetic cardiomyopathy, reversible by coenzyme Q10 upplementation.http://www.fda.gov/ohrms/dockets/dailys/02/May02/052902/02p-0244-cp00001-02-Exhibit_A-vol1.pdf

Oral Supplementation of CoQ10 in Diabetic Patients Increased Serum Coenzyme Q10 Levels

Without Affecting Cholesterol Levels

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After the patient’s first heart attack, fluids don’t get pumped out of the system rapidly enough.So patient gets prescribed spironolactone to relieve edema (fluid retention) from various conditions including congestive heart failure, kidney disease, and cirrhosis (liver scarring).

Unfortunately, the combination OF LOSARTAN & SPRONOLACTONE is contraindicated for diabetics and heart failure patients because it causes hyperkalemia,

or excess potassium, putting stress on the kidneys , which could lead to kidney failure.

After Heart Failure, Patient Gets Prescribed Spironolactone, Incurring a Major Adverse Interaction with Previously Prescribed Losartan Which Could Lead

To Kidney Failure

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As an Additional Response to Congestive Heart Failure, Patient Gets Prescribed Warfarin, Which Also Causes

Arterial Calcification

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As the diabetes progresses, patient gets switched from metformin to humulin. As vascular calcification progresses, leg wounds start to appear and get treated topically, and with antibiotics for a presumed infection. Hydocodone gets prescribed for increasing leg pain.

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Interactions between your selected drugsModerate: furosemide cephalexinApplies to: furosemide, cephalexin

Cephalosporin antibiotics like cephalexin can occasionally cause kidney problems, and using it with furosemide may increase that risk. The interaction is more likely to occur when the cephalosporin is given at high dosages by

injection into the vein or when it is given to the elderly or individuals with preexisting kidney

function impairment

Another hit on the kidneys.

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A month after receipt of these drug combinations, patient lost the ability to walk. He would get up and fall to the floor. Paramedics had to be called to pick him up and bring him to clinics or the hospital. We thought it was the painkillers.

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Misdiagnoses of Arterial Calcification.

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As pain from the arterial calcification built up, patient was prescribed narcotic combinations which further

stressed the kidneys.

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It was only after an attempt at debridement was made on the patient, (during which he bled so profusely they had to postpone the operation for a few days until the combination of drugs that led to excessive bleeding wore off), and he was admitted to the hospital for his final stay, that other conditions were identified.

They started putting him on dialysis because his kidneys were failing. He had arrhythmias but they postponed putting a pacemaker in him because of the perceived infection in his leg.

It was not until two weeks before he died that the brightest doctor at the HMO popped into the hospital room and informed us the patient had calciphylaxis-aka calcification of the arteries.

Calciphylaxis? Or calcification from statins and warfarin?

Patient coded 4 times on a dialysis machine two weeks later, two days after he was given Zoloft (which shouldn’t have been given due to renal insufficiency).

While in the hospital, patient requested that his case history be used for teaching, as he had been an anatomy and physiology lecturer. So be it. R.I.P.

Final Hospital Stay

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