Generic Amaryl (Glimepiride) Information

Abnormal cholesterol levels can significantly increase the risk of heart failure, a new study has found.

U.S. researchers analyzed data on 6,860 participants in the National Heart, Lung, and Blood Institute’s Framingham Heart Study. None of the participants, average age 44, had coronary heart disease at the start of the study. After about 26 years of follow-up, 680 people had developed heart failure.

The incidence of heart failure was:
12.8 percent in participants with low levels of high-density lipoprotein (HDL, or “good”) cholesterol. Low HDL is less than 40 milligrams per deciliter (mg/dL) in men and less than 50 mg/dL in women.
6.1 percent among participants with desirable HDL levels (at least 55 mg/dL in men and 65 mg/dL in women).
13.8 percent in participants with high levels (at least 190 mg/dL) of non-HDL cholesterol, which includes triglycerides and low-density lipoprotein (LDL, or “bad”) cholesterol.
7.9 percent in those with desirable levels (less than 160 mg/dL) of non-HDL cholesterol.

When the researchers factored in age, sex, body mass index, blood pressure, diabetes and smoking, the risk of heart failure was 29 percent higher in participants with high non-HDL cholesterol than in those with lower levels, and 40 percent lower in those with high HDL-cholesterol than in those with lower levels.

Further analysis showed that the risk of heart attack was 13 percent higher in participants with high non-HDL cholesterol and 25 percent lower in those with high HDL cholesterol.

“This study goes a step further in implicating cholesterol levels (both HDL and non-HDL) in heart failure and suggests that cholesterol-altering therapy may have long-term benefits in preventing heart failure above and beyond its effects on preventing [heart attack],” study senior author Dr. Daniel Levy, director of the Framingham Heart Study, said in a news release from the American Heart Association.

Adult stem cells from bone marrow can prevent acute lung injury in mice, U.S. researchers report.

Acute lung injury, which is caused by major inflammation or injury to the lungs, causes about 74,500 deaths each year in the United States. There is no effective drug treatment for the condition, which is a major cause of death among patients in intensive care units.

A team at the University of Illinois at Chicago College of Medicine identified progenitor stem cells in the bone marrow of mice that could prevent and treat acute lung injury. The researchers also found a way to culture the cells — called Flk-1 and CD34 — to increase their numbers and ability to attach to targets and make repairs.

When the purified and cultured Flk-1 and CD34 stem cells were injected into mice with acute lung injury, the cells repaired the lung injury, prevented fluid build-up and improved survival of the mice, the researchers found.

The study not only showed that stem cell treatment may be a promising therapy for acute lung injury, “but also provided us with the means to understand how these progenitor cells did their repair work. These therapeutic cells employed integrins to stick to the site of injury and turn on cellular and molecular repair machinery,” lead author Kishore Wary, an assistant professor of pharmacology, said in a university news release.

The researchers hope to test this stem cell therapy in human acute lung injury.

Americans are more likely than people in 10 other countries to have trouble getting medical treatment because of insurance restrictions or cost, an international survey of primary care doctors released on Wednesday found.

While the United States spends more than twice as much as other developed countries on healthcare, it lags well behind in key measures of quality, the annual survey found.

“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” said Karen Davis, president of the Commonwealth Fund, a private health policy group that sponsored the survey.

“The survey provides yet another reminder of the urgent need for reform that makes acceptable, high-quality care a national priority,” Davis told a news briefing.

Other countries have solved problems the United States is still struggling to conquer, she said.

The survey of more than 10,000 primary care doctors in 11 developed countries — Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden and the United Kingdom — found problems in all of them.

In the United States, cost and access to care stood out as a major challenge for primary care doctors.

“The majority of U.S. doctors — some 58 percent — say their patients often have difficulty paying for medications and other medical care, by far the highest rate in the survey,” Cathy Schoen of the Commonwealth Fund, whose study appears in the journal Health Affairs, told the briefing.

Paying for healthcare was a problem in 5 to 37 percent of other countries surveyed.

Insurance restrictions, such as provisions to limit or control medication or treatment, are a major impediment for U.S. doctors, with half of 1,400 physicians surveyed saying the time they and their staff spend dealing with insurance companies is a major problem.

The survey from February to July 2009 was conducted by mail, online and by phone.

AFTER HOURS

“It appears that U.S. doctors are adding staff to their offices that would not be typical of other countries just to cope with our complex, fragmented insurance system and advocate for their patients,” Schoen said.

The survey also asked doctors if patients in their country could see a doctor after regular business hours without being forced to go to the emergency room.

Nearly all doctors surveyed from the Netherlands, New Zealand and the United Kingdom said this was offered, compared with just 29 percent of doctors in the United States — which ranked lowest in the survey.

“The vast majority say they have no arrangement at all,” Schoen said, adding that the 29 percent figure is a drop from 40 percent reported in 2006.

By contrast, doctors in the United States and Britain were least likely to say their patients faced long waits to see a specialist, compared with Canadian and Italian doctors, who were most likely to say this was a problem.

The study also shows the United States and Canada trail other developed countries in the use of basic electronic medical records. Less than half of U.S. doctors (46 percent) say they have electronic medical records, and just 37 percent of doctors in Canada have them.

Electronic medical records are nearly universal in the Netherlands, New Zealand, the United Kingdom, Australia, Italy, Norway and Sweden.

“The findings underscore the extent to which national policies matter,” Schoen said.

Agency also releases drug dosage guidance for measuring devices included with OTC medications

The U.S. Food and Drug Administration today announced the Safe Use Initiative, a program aimed at reducing the likelihood of preventable harm from medication use.

“Too many people suffer unnecessary injuries from avoidable medication misuse, errors and other problems. The FDA is launching the Safe Use Initiative to develop targeted solutions for reducing these injuries,” said FDA Commissioner Margaret A. Hamburg, M.D.

Millions of people are harmed every year from inappropriate medication use. Many injuries occur as a result of incomplete access to information about a drug, a patient, or the patient’s condition.

Other preventable sources of harm include unintentional misuse of medications, medication abuse, and attempts at self harm. Unintended exposure to prescription medications such as opioid drugs can cause harm, even death, in a single dose, if taken by someone other than the patient who was prescribed the medication.

“Only through coordinated interventions across all sectors of the health care system can we substantially reduce preventable injuries from using medications,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “All participants in the health care community have a role to play in reducing the risks and preventing injuries from medication use.”

More detailed information on the new program was contained in a report, titled, “FDA’s Safe Use Initiative – Collaborating to Reduce Preventable Harm from Medicines.” The report was released by Drs. Hamburg and Woodcock at FDA’s annual Science Writers Symposium at the agency’s White Oak Campus in Silver Spring, Md.

As outlined in the report, the FDA intends to collaborate with health care professionals and other stakeholders to identify drugs and drug classes that are linked to preventable harm. A list of specific problems, cross-sector interventions for reducing harm from these problems, and the metrics for success will be developed.

The report highlights several risk-reduction projects that may benefit from Safe Use collaborations, including evaluating consumer medication information, communicating about the risk of inadvertent overexposure to acetaminophen, implementing safeguards against surgery fires caused by alcohol-based surgical preps, and avoiding contamination of multiple use medication vials.

To further advance the Safe Use Initiative, the FDA intends to hold a series of public meetings to gather feedback as the candidate list is being developed and will open a public docket to receive comments on the report and proposed candidate cases.

The agency also today made public new FDA guidance for companies that manufacture, market, or distribute over-the-counter liquid medications packaged with dosage delivery devices such as calibrated cups, droppers, syringes and spoons.

The guidance document, titled “Dosage Delivery Devices for OTC Liquid Drug Products,” was posted for advanced viewing in the Federal Register today.

Accidental overdoses can be caused by dosage delivery devices that are unclear or are inconsistent with the labeled dosing instructions.

“This new drug dosage guidance document is an example of steps that can be taken to ensure safer medication use,” said Woodcock. “Many accidental overdoses result from confusion about exactly how much of a drug to take. Better measuring devices will help patients, parents, and other caregivers use the right amount of these medications – the safest and most effective dose – especially for children.”

Most Americans don’t eat the recommended amounts of fruits and vegetables, says a U.S. government study released Tuesday. And no state has achieved national objectives for consumption of fruits and vegetables, it found.

The goal for the Healthy People 2010 program is to get at least 75 percent of Americans to eat the recommended two or more daily servings of fruit and for at least 50 percent of Americans to consume three or more daily servings of vegetables.

But surveys from the U.S. Centers for Disease Control and Prevention show that only 33 percent of adults meet the fruit consumption target and only 27 percent eat the recommended amount of vegetables. The statistics are worse for high school students — only 32 percent eat the recommended amount of fruit and 13 percent meet the goal for vegetables.

“A diet high in fruits and vegetables is important for optimal child growth, maintaining a healthy weight, and prevention of chronic diseases such as diabetes, heart disease and some cancers, all of which currently contribute to health care costs in the United States,” Dr. William H. Dietz, director of the CDC’s Division of Nutrition, Physical Activity and Obesity, said in a CDC news release.

“This report will help states determine what is taking place in their communities and schools and come up with ways to encourage people to eat more fruits and vegetables,” Dietz said.

The report — the State Indicator Report on Fruits and Vegetables, 2009 — is the first to detail state-by-state data about fruit and vegetable consumption and policies that may help boost fruit and vegetable consumption.

It spotlights three important policy and environmental areas associated with fruit and vegetable consumption: healthier food retail, availability of healthier foods in schools, and food system support.

Food stores that stock a variety of high-quality fruits and vegetables can play a key role in residents’ health, the report notes. But only eight states have a policy for healthier food retail improvements that can increase the number of full-service grocery stores in areas where they’re lacking, increase the availability of healthier foods in small food stores, and promote healthier foods by providing information to consumers in food stores.

Schools can influence better eating by students, staff, parents and other members of the community. But the report found that only 21 percent of U.S. middle schools and high schools offer fruits and non-fried vegetables in vending machines, school stores or snack bars. Fewer than half the states (21) have policies to support farm-to-school programs that can increase access to fruits and vegetables and teach students about nutrition and agriculture.

The report also mentioned food policy councils, which are organizations that look at access to fresh produce at the community and state levels. Food policy councils make recommendations about policies and programs such as community gardens, farmers’ markets, availability of fresh produce in supermarkets and farm-to-school programs. Currently, 59 local food policy councils operate across the United States, and 20 states have a state-level food policy council.

“We have seen the tremendous benefit of state and local officials, health professionals, employers, food store owners, farmers, school staff, and community members working together on food and nutrition issues,” CDC epidemiologist Heidi Michels Blanck said in the news release. “Their efforts can help to increase the availability of affordable healthier food choices such as fruits and vegetables.”

Some studies have suggested that strep throat may cause or trigger obsessive-compulsive disorder and Tourette syndrome, but extensive new research has found no evidence of a link.

“Streptococcal infection has previously also been linked to other, much rarer neuropsychiatric disorders,” Dr. Anette Schrag of the University College London and an author of the study said in a news release from the American Academy of Neurology. “These results do not confirm other, smaller studies done in the U.S. which found an association between strep infection and these brain disorders.”

The study involved 255 residents of the United Kingdom, 2 to 25 years old, including 129 who had obsessive-compulsive disorder (OCD) and 126 with Tourette syndrome or tics, a symptom of that condition. The researchers compared incidents of strep throat infection in the 255 participants with that of 4,519 people who had neither condition.

Of those with OCD, about 15 percent had possible exposure to strep throat in the two years before they were diagnosed with their disorder; that was the case for 10 percent of those with Tourette syndrome. The rates were similar to those in the group without the conditions, the study found. The researchers found similar rates of strep infection five years before diagnosis as well.

This suggests, according to the researchers, that strep throat does not have a connection to either disorder.

Despite 14 years of public education campaigns, only one-third of Americans know about national recommendations for a minimum of 30 minutes of exercise a day, and fewer than half meet that goal, a new study has found.

The lack of awareness is greatest among men, the unemployed and people born in the United States, the researchers said. Their finding came from an analysis of data from 2,381 people who took part in the 2005 Health Information National Trends Survey.

One reason why efforts to spread the message about physical activity are having limited success is the “highly generalized, saturating effect of media in the current environment,” the authors wrote. “Through varied sources, many are bombarded with multiple physical activity and general health promotion ‘recommendations’ that may be challenging to differentiate.”

A report on the study is in the October issue of Medicine & Science in Sports & Exercise.

Since 1995, the U.S. government and national organizations have used radio, TV, print publications and the Internet to make Americans aware they should be doing at least 30 minutes of moderate physical activity each day.

If more people followed the recommendations, it could help reduce rates of chronic health problems, said the study’s lead author, Gary Bennett, an associate professor of psychology and neuroscience at Duke University.

“Physical activity is important for protecting against a large number of chronic diseases, including cardiovascular disease, some cancer, diabetes, even some cognitive disorders,” Bennett said in a Duke news release. “So the physical activity recommendations are extremely important to help increase awareness among the American population about the amount of physical activity that is necessary to reduce the risk of developing these diseases,” he added.

“We’ve seen a lot of discussion about prevention in health-care reform debates over the last few months, and it’s becoming clear that increasing physical activity among Americans may, in the long run, reduce some of the major costs that burden our health-care system,” Bennett said.

Glimepiride is used to treat high blood sugar levels caused by a type of diabetes mellitus (sugar diabetes) called type 2 diabetes. In type 2 diabetes, your body does not work properly to store excess sugar and the sugar remains in your bloodstream. Chronic high blood sugar can lead to serious health problems in the future.

Proper diet is the first step in managing type 2 diabetes, but often medicines are needed to help your body. Glimepiride belongs to a class of drugs called sulfonylureas. It causes your pancreas to release more insulin into the blood stream. Glimepiride may be used alone, or in combination with insulin or another oral medicine such as metformin.

Glimepiride is available in the following dosage forms:
Tablet