Thursday, March 06, 2008
Some medications have more than one use

By Dr. Anthony Policastro

When the FDA approves drugs, it does so after research studies are completed on those drugs. They then give the drug manufacturer the ability to market the drugs. The drugs can be marketed for problems that were identified through the research. Thus if a drug is studied as a blood pressure medicine, it can be used for that problem. The drug has a package insert that says that. Such a use for the drug is a labeled use of the drug. However, there are many instances in which drugs are used for other purposes. These are called off label uses of the drug. There are several possible reasons for off label uses of a drug. One of those is related to a drug that might be used for a different illness than it was researched for in the first place. For example rogaine was originally a blood pressure medication. When it was found that one of the side effects was hair growth, it was used for that purpose. In the early days of that, hair growth was an off label use of the drug. Wellbutrin is an antidepressant. We later found that it could also be used to help people stop smoking. In most cases, these other uses for drugs are added to the label at a later time. Then it is no longer an off label use of the drug. Another possibility, is that some drugs are studied in certain age groups. They are then approved for those age groups. Frequently, they are used in other age groups. This is also an off label use of the drug. We do this very commonly in pediatrics. There are a lot of drugs that are approved for use in children over 12. Some are approved for use in children over 6. Others are approved for use in children over 2. There are many times when we use drugs like this in younger children. Just because the research did not include younger children, does not mean that the medication will not work. However, this sometimes causes problems. Last week I ordered some nose drops for a 2 year old with a stuffy nose. They are usually used in children over 6. I have been using them successfully for years in children as young as 2 months of age. When the parents went to get the prescription filled, they read that the medication should not be used in children under age 6. They panicked about that. All it means is that the research did not study them in children under age 6. It does not mean that they are forbidden to be used in that age group. I also had a hyperactive child this week for whom I prescribed Ritalin. The child's insurance company would not approve the prescription. Their reason was that Ritalin has not been "proven to be safe and effective in children under 6." That is true. Fortunately it works well for children under age 6 who have severe ADHD. It is an acceptable off label use of the drug. There are many examples of both of these kinds of off label uses of drugs. For that reason, if you read the package insert on a medication, it does not mean the physician was incorrect. It just means that you should ask the question about off label use for your particular drug.

Del Tech offers first aid
Parents, teachers, coaches, and day care providers can increase their caregiving and safety skills with courses in pediatric first aid, basic first aid and cardiopulmonary resuscitation (CPR) at Delaware Tech, Owens Campus. Pediatric First Aid covers managing pediatric emergencies including: insect bites, convulsions, burns, poisoning, drowning, fractures, sprains and bleeding. This two-session course is approved by the Office of Child Care Licensing. Participants must attend both sessions to receive a three-year course completion certificate. For those whose jobs require certification of CPR and basic first aid skills, the college offers courses that teach adult (one-rescuer) CPR and relief of foreign body airway obstruction as well as hands-on skills for quick response in medical emergencies and first aid situations. Those who pass the written exam earn a two-year course completion card. The Pediatric First Aid courses will be held from 6 to 9 p.m. on March 10 and 12 as well as April 7 and 9. CPR & Basic First Aid is a one-session class and will be held from 8:30 a.m. to 4:30 p.m. on March 14, March 29 and April 23. For more information, contact Delaware Tech's Corporate and Community Programs at 854-6966.

Volunteer at Delaware Hospice
Delaware Hospice volunteer Judy Goldhammer encourages others to get involved during the Spring volunteer information sessions in March. "As a hospice volunteer, you're helping other people, and I always feel that I get more than I give my patients and families," said Judy Goldhammer, Delaware Hospice Kent County volunteer. "You receive information from a variety of disciplines; the nurse, social worker, chaplain, volunteer coordinator, bereavement counselor, and even the volunteers themselves. This helps you to understand the various facets of the program and decide whether or not you'd like to become a patient/family support volunteer. And you never go out blind." Visiting patients may not be for everyone, however, and Delaware Hospice volunteers help out in many other ways. Those who want to get involved with the not-for-profit organization might assist in organizing fundraising events, support staff members with clerical needs or bake cookies for Camp New Hope. The Delaware Hospice Center, expected to open in April, will also offer unique opportunities for you to give a helping hand – receiving visitors, visiting with guests, creating flower arrangements, serving tea, and more. Delaware Hospice will hold its Spring Volunteer Information Sessions throughout March and welcomes your involvement. Registration is required. To register for an upcoming training or to find out more about volunteering for Delaware Hospice, in Sussex County, contact Mary Costello, 855-2344, ext. 4120, or write to mcostello

OWH launches first e-newsletter
The Delaware Division of Public Health's (DPH) Office of Women's Health (OWH) announces the launch of it's first e-newsletter, linking readers to important health information and reliable sources that promote optimal health and well-being among all women and girls in Delaware, across the lifespan. Women's health issues and treatment disparities have only recently become a source of scrutiny, despite long-standing concerns. When the OWH was initially established in 2001, its primary activity was supporting the annual Women's Wellness Expo in Dover. However by 2007, the need for attention to women's health issues and the consideration of biological, psychological, environmental and social factors to women's health prompted the OWH to assume more action. Jacqueline Christman, MD, appointed as OWH director, began forming a partnership committee of representatives from health care, private individuals, and state and community agencies. In Dec. 2007, the group met and reviewed a health analysis of Delaware's women. The analysis found that:
  • Of 439,916 women in Delaware, 65,902 women are over age 65 and nearly 40 percent of them have some form of disability.
  • More than 10 percent of women ages 18-24 do not have health insurance.
  • The leading causes of death among Delaware women are (in order of frequency): heart disease, malignant invasive tumors, cerebrovascular diseases (stroke), lower respiratory diseases, diabetes, Alzheimer's and accidents.
  • The OWH newsletter will connect women and their providers with news, findings, events and more. For questions or to receive the e-newsletter, call 302-744-4702 or e-mail

    ACS plans benefit for March 16
    The Lighthouse Restaurant, located at Fisherman's Wharf, 7 Anglers Road, Lewes, is donating the restaurant's pavilion area as the site for an American Cancer Society (ACS) benefit on Sunday, March 16 from 10 a.m. to 4 p.m. "Spruce Up for Spring and Summer: Caring for the Mind, Body and Soul," is the theme of the ACS Relay for Life 2008 fundraising event as vendors from across Sussex and Kent counties bring their products, information and expertise in hopes of raising contributions and awareness for cancer patients and caregivers. Paul and Mary Buchness, owners and operators of the Lighthouse Restaurant, are longtime supporters of ACS Relay for Life. The ACS Relay for Life 2008 benefit is open to the public. Along with ACS information booths, vendors offer an array of specialty products from skin care to chocolates, handbags to spring and summer houseware gifts and much more. For more information, contact the Ribbon Cap Club team at 422-7878 or e-mail

    Depression support group in Laurel
    The Mental health Association in Delaware will be sponsoring a Depression Support Group in Laurel on the second and fourth Thursdays of each month. The meetings begin at 7 p.m. The MHA encourages anyone dealing with a depressive disorder to attend. Register in advance by calling 1-800-287-6423. Peer support groups sponsored by Mental Health Association of Delaware are not intended to replace professional mental health treatment. MHA does not publish support group locations; locations are provided with registration.

    Stroke support group
    Nanticoke Memorial Hospital will offer free monthly Stroke Support Group meetings designed for individuals who have survived a stroke and their families and caregivers. Meetings are held the third Thursday of each month at Nanticoke Cancer Care Center, from 1:30 - 3:30 p.m. The meetings will consist of guest speakers and breakaway sessions, in which caregivers and survivors will meet in two groups to discuss concerns, provide support and networking. Refreshments will be provided. Sheila Brant and Joan Burditt, occupational therapists at Nanticoke Memorial Hospital, will facilitate the support group meetings. Pre-registration is not required. For more information, call 629-6611, ext. 5121.