12th September, 2011: Experts at Warwick Medical School are piling on the pressure for us to be more aware of how to keep our blood pressure healthy. To tie in with National Blood Pressure Week (12-18 September), Professor Donald Singer, Professor of Clinical Pharmacology and Therapeutics at Warwick Medical School is urging everyone to get their blood pressure checked as it affects so many aspects of our health.

But for many, the numbers that doctors quote don't mean anything; so what do they mean and what would be considered high? Professor Singer explained that the two numbers used both predict risk. They show the different pressures when the heart has contracted and when the heart is relaxed between heartbeats...

24.8.11 High blood pressure is a major preventable and treatable risk factor for heart disease and stroke syndromes both in the developed and the developing world.

In an innovative partnership between a UK government agency - the National Institute for Health and Clinical Excellence (NICE) - and a professional organisation - the British Hypertension Society (BHS), NICE guidelines for managing hypertension in primary care were first issued in 2006. On 24th August 2011, five years on, NICE, again supported by experts from the BHS, has released updated hypertension guidelines, which include several key developments of interest to prescribers and patients. These include changes in advice on use of blood pressure monitors and medicines ...

24.6.11 Professor Donald Singer interviewed by Annie Othen on BBC radio about a report in the British Medical Journal by Schmidt and colleagues from Denmark, North Carolina and Boston, USA on 'Non-steroidal anti-inflammatory drug use and risk of atrial fibrillation or flutter ..." [http://www.bmj.com/content/343/bmj.d3450] Professor Singer notes that ‘This large study from Denmark concerns patients prescribed the powerful pain-killer and anti-inflammatory drugs NSAIDs and COX-2 inhibitors. The authors suggest that the serious heart rhythm disorders atrial fibrillation or flutter may occur in an annual increase of 7 out of a thousand patients in the first year on these medicines. With longer term treatment the reported additional annual increase risk is smaller at up to 3 patients per 1000.There are some major flaws in the study. This was not the highest quality design in that it was not a randomised study and therefore open to many types of bias. For example patients on the drugs were a third more likely to have had known previous heart disease (80%) than in the control population (59%). And no information was available on non-prescribed ‘over-the-counter’ use of drugs. NSAIDs and COX-2 inhibitors should be prescribed based on careful weighing up of their benefits and risks. Patients on these medicines who develop palpitations or other features of heart problems, including shortness of breath or ankle swelling, should consult their GP for advice.’

24.6.11 Professor Donald Singer interviewed by Annie Othen on BBC radio about a report in the Journal of the American Geriatric Society that suggests increased risk of mortality and mental impairment in older people from some medicines used in combination. Professor Singer notes that the study relies on events and clinical practice from almost 20 years ago. Since then, there have been many changes in how and what drugs are used. The study is not randomised and therefore open to many types of bias. The researchers cannot exclude the diseases being treated or other non-drug factors as the cause of increased mortality or cognitive impairment reported.

March issue of parenting journal 'Junior': Professor Donald Singer comments on possible link between paracetamol use and later onset of asthma. Reverse causation may explain aspects of reported link between paracetamol use and asthma: respiratory infections in early life are known to predispose to asthma, and paracetamol may be used to relieve symptoms of those infections. 

22nd Jan 2011: Professor Donald Singer interviewed by Malcolm Boyden on BBC Coventry and Warwickshire Radio. From new USA experimental research on effects of caffeine and aspirin-like medicine on 'hangover', to old remedies [anyone for Pliny the Elder's fried canaries and raw owls eggs?].
Prof Singer discussed guidelines on sensible alcohol intake, including avoiding binge drinking within a [UK] weekly upper limit of 21 units, less e.g. for younger or elderly people, the lean, patients with a wide range of medical problems [e.g. high blood pressure, heart disease or liver disease] and people on medicines which interact with alcohol.
The evidence is that 'hangover cures' at best reduce symptoms but do not return performance to normal - and aspirin-like painkillers increase the risk of serious stomach ulcers and bleeds, even more so when linked to high alcohol intake. 
See the excellent NHS website on alcohol for tips, downloadable phone apps and other helpful advice.

12th Jan 2011

BPS Members Professor Simon Maxwell, Professor Philip Bath and Professor Donald Singer respond to to BMJ Article, Jan 2011: Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis.

Jan 2011: MW Hulse and DRJ Singer.  We are creatures of language, and it's through language that we confront our afflictions of body and mind. It was to serve this understanding that the International Hippocrates Prize for Poetry and Medicine was established ...   In its twin categories of award, it reflects the fact that professional writers are drawn to medical subjects, while those who work in health services are no less likely to want to put their thoughts and feelings on paper.  For the ancient world, writing on scientific subjects in verse was the most natural thing in the world ... a tradition of writing in verse on medical matters can be traced down the centuries, in many parts of the world ... 

25th Nov 2010: Just over a century ago, German chemist ... Felix Hoffmann was ­searching for a drug that could alleviate his father’s pain from arthritis. He came across an old formula for a painkiller made from an extract of willow bark. ... His father’s suffering was indeed much reduced after taking the compound...  Within two years the new drug was the number one medicine in the world. ...  aspirin does not suit everyone. A major side-effect is bleeding in the stomach ...  unsuitable for people suffering from certain kinds of adult asthma ...  can provoke bleeding in the brain. “It is a case of weighing up the side-effects against how much it relieves the condition you’re treating,” says Professor Donald Singer ...

Dr Michael Eddleston talks to Prof Donald Singer about his work on organophosphates in South East Asia. This vodcast was recorded at the BPS Winter Meeting in 2009. To see Dr Eddleston's lecture (Applied clinical pharmacology in rural Asia - preventing deaths from organophosphate pesticides) in full, go to the Video Resources page at: www.bps.ac.uk. 

13th Oct 2010: KnowledgeCentre interview with Professor Donald Singer.

There is a wide range of reasons for adverse drug reactions, including not following safety guidelines (such as avoiding alcohol), taking contaminated drugs from an unregulated source, or an unforeseen interaction between two drugs...

7th October, 2010:  Professor Donald Singer quoted from his Science and Media Centre response to new NICE draft guidance on Alzheimer's Disease. 'The proposal by NICE to extend its guidance to include access for 3 drugs (donepezil, galantamine and rivastigimine) to patients with much milder disease than previously eligible is excellent news for patients with Alzheimer's disease and their families. It is also very encouraging to have in the guidance a new treatment option (memantine) for patients with more severe disease ...'

See related University of Warwick page

27th Sep 2010:  Professor Donald Singer in live TV interview on BBC Arabic TV Live News on the 26th September Nature Medicine report on a new gene abnormality in migraine with aura - a dominant-negative mutation in the TRESK two-pore domain potassium channel.
The normal pain-reducing actions of the channel are lost in the presence even of a single mutant gene. This may both provide a new biomarker to help in treatment choice in migraine and may give clues to development of new treatment approached in selected patients - a further advance in personalising medicines ...
See Nature article: http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.2216.html

24th Sep 2010: With short term and long term recreational use, adverse effects can be troublesome and may be serious. Nitrous oxide is a depressant of the central nervous system. People feel uninhibited when they take it, but large amounts over a short time frame can lead to serious depression of brain function.  The problem with nitrous oxide with long term recurrent use is that it interferes with vitamin B12, which is vital for blood cell function. It is also vital for normal nerve and brain function.  People at risk from a B12 deficiency can incur damage to their spinal column, nerves and brain.

25th Sep 2010: Overnight the European Medicines Agency (EMA) has recommended the suspension of the marketing authorisations for the anti-diabetes medicine Avandia (Rosiglitazone). These medicines will stop being available in Europe within the next few months...

24th Sep 2010:  Comment at New Zealand Science and Media Centre by Professor Donald Singer on EMA and FDA decisions on the Type 2 diabetes medicine rosiglitazone [Avandia]. People with diabetes are at increased risk of cardiovascular disease.  Despite lowering blood sugar, there is increasing concern that the tablet treatment for Type 2 diabetes rosiglitazone may in fact increase risk of heart failure and other serious cardiovascular disorders. Both the European Medicines Agency (EMA) and the US drugs regulator, the Food and Drug Administration (FDA) have today issued important new guidance placing major restrictions on the use of rosiglitazone. The EMA recommended suspension of the drug throughout Europe, either as separate treatment or in combination tablets …

8.9.10  Jane Dutton interviews Professor Donald Singer on @AJEnglish TV News on cardiovascular risks of anti-diabetic drug rosiglitazone ...

6th Sep 2010: Doctors continued to prescribe one of the world's most popular drugs for the treatment of diabetes - despite having been warned two months ago that it can cause heart attacks... 

12th August 2010: The end of antibiotics? Is the era of antibiotics nearly over?  Listen to Professor Donald Singer's interview on BBC Three Counties Radio...

See related article by Guardian Health Editor Sarah Boseley on 12th August 2010: We have a window of maybe 10 years. 

 August 2010: More and more string players rely on beta blockers, but few are open about using them. Catherine Nelson talks to musicians and medical experts about the drugs’ risks and benefits, and why their use is still such a sensitive subject. Beta-blocker use by musicians discussed by Professor Donald Singer, University of Warwick and Nick Roberts, Coull Quartet cellist...

11th Dec 2009: Governments have been stockpiling the anti-viral drug oseltamivir as a defence against pandemic flu. Now the medical journal BMJ has claimed there is insufficient evidence that the drug prevents serious complications of flu to warrant the policy. In a series of articles, it says ...

27th March 2010: A genetic test that predicts how patients with mental illnesses such as depression and schizophrenia will respond to drugs is to be offered to British doctors, in a step towards a new era of personalised medicine. ... uses individuals’ DNA to assess whether 26 psychiatric drugs ... are likely to work or cause side-effects. It promises to bring significant improvements to the care of patients with psychiatric conditions, at least a third of whom do not currently benefit from the first drug they are prescribed because they cannot tolerate it or it has no effect. The development highlights the growing potential of genetics to tailor treatment according to patients’ DNA profiles. This practice, known as pharmacogenetics or pharmacogenomics, is expected to transform many branches of medicine over the next decade ... 

11th Feb 2010: Article on medical myths ...

17th March, 2008: More than 3% of all deaths seem to be caused by adverse reactions to medical drugs, according to new research. If substantiated by further work, this would make 'fatal adverse drug reactions' (FADRs) the seventh most common cause of death in Sweden, where the research was done ...

4th Feb 2007: THE growing use of laughing gas as a recreational drug among middle-class party goers has claimed its first fatality in Britain ...

14th Feb 2005: Schools across Warwickshire and Coventry are leading the way in healthy living by taking part in a unique competition to promote healthy ideas. Over thirty primary and secondary schools have so far taken up the challenge and will design posters, pamphlets, dvd's and websites to encourage a greater interest in health across the whole community... 

26th Nov 2005:  Nitrous oxide, like other inhaled gases, is a depressant of the central nervous system. People initially feel uninhibited but large amounts can lead to ...