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July 12, 1995

Problem Drugs

Author Affiliations

Cornell University Medical College New York, NY

JAMA. 1995;274(2):184-185. doi:10.1001/jama.1995.03530020102045

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Problem Drugs is a polemic against some of the marketing practices of many members of the pharmaceutical industry and against the excessive prescribing of medications by many physicians, often in response to those marketing practices. Each chapter is a stand-alone essay about a specific alleged evil practice, ending with recommendations for action.

Practices criticized include promotion of antibiotic use for people with general infections often due to organisms not responsive to antibiotics, such as viruses, and promotion of some drugs, often nonsteroidal anti-inflammatory medications, as being good for people of all ages when, in fact, the elderly are at greater risk.

Some, such as urging the universal banning of antidiarrheal products containing hydroxyquinolones or strict governmental control over the claims made for vitamin preparations, are reasonable and appropriate. Others, such as the recommendation that estrogen replacement therapy "should not be recommended for widespread use by all menopausal or postmenopausal women,"

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