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Painkillers, heart drugs top list of common Rxs LAST YEAR'S TOP 10 Rxs
The top 10 most-prescribed drugs of 2007 shed light on America's health problems

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BEN FREDMAN/THE FREE LANCE-STAR
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Date published: 6/22/2008

BY MEGAN WILLIAMS

A lot can be learned about America's health problems by looking in its medicine cabinet.

A list of the 10 most commonly prescribed drugs in 2007, published by Drug Topics magazine, reveals much about the way Americans' lifestyles and genes affect their health.

Five of the most frequently prescribed drugs treat heart problems, according to the list, compiled by Verispan, a provider of patient data.

Two drugs in the top 10 are antibiotics, while others treat conditions including thyroid disorder, pain and anxiety.

The list indicates a shift from the days when infectious diseases--treated by antibiotics--were the main cause of death to an era when lifestyle-related conditions--caused by things like poor diets--are more common. Top 10 prescribed drugs :

Despite concerns about abuse and addiction, hydrocodone is the standard drug for pain management, according to Dr. Selwyn Adams, a Fredericksburg family practitioner.

"It's effective," Adams said. "It's written a lot for injuries, headaches, everything in between."

The painkiller is found in drugs such as Vicodin and Lorcet. It's also found in prescription cough syrups, as it's effective at suppressing coughs.

Goolrick's pharmacist Steve May said prescriptions for hydrocodone, an opiate, come from emergency rooms more often than from other doctors' offices.

Although hydrocodone can be a strong narcotic, it is typically mixed with acetaminophen to vary and minimize its strength.

If used for a short period of time, habit formation is usually not a problem. But extended use of hydrocodone can lead to dependency.

"Hydrocodone diversion and abuse has been escalating in recent years," the U.S. Drug Enforcement Administration says on its Web site.

Lisinopril, an ACE inhibitor, is used to treat high blood pressure and congestive heart failure. It is also often prescribed to prevent a second heart attack.

It is the first of five prescriptions in the top 10 related to cardiovascular health. All five are generic drugs, which tend to be cheaper than brand-name medicines.

Because of their lower cost, "It's a little heartening that these five generic drugs are in the top 10," said Dr. Robert Vranian, a Fredericksburg cardiologist.

Heart problems can't be solved completely with medication, doctors say. Lifestyle is a big factor.

"Obesity is on the rise," said Adams, the family practitioner. "Overall, we have a more sedentary lifestyle."


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To see a list of the 100 most commonly prescribed generic and brand-name drugs, visit drugtopics .modernmedicine.com.

--Drug Topics/Verispan

Commonly known as a Z-pack, this antibiotic has become popular in the last few years. Between 2006 and 2007, the number of prescriptions written for it rose 25.6 percent.

The convenience of the five-day dosage in pill form is the cause of its recent upswing in popularity, according to Adams and May.

Although azithromycin and amoxicillin do the same job--fight bacteria--they are derived from different families of drugs and therefore fight bacteria in different ways.

Atenolol is a beta blocker, which helps lower blood pressure. It is often prescribed to people who have had a heart attack to prevent a second one.

It is the only prescription drug on the list to have decreased in the number of times it was prescribed in the past year--a drop of 1.4 percent.

"It's the most-used beta blocker in the world and the least effective," said Vranian, the cardiologist.

It's the least effective, Vranian explained, because it is often prescribed by physicians as a once daily medication when it should be taken twice daily.

Atenolol is effective for 18 hours when taken once daily. So for six hours, usually in the early mornings when people need it most, they're not getting it, Vranian said. Heart attacks often strike in the morning, when blood pressure rises, studies have shown.

Used to lower cholesterol, this prescription drug saw a 215.6 percent increase in popularity from last year. This significant increase is because it has gone generic, making it cheaper. (It's brand names include Zocor.)

"It's one of those drugs where if you don't have insurance, it can be really expensive [in its brand-name form]," Adams said. "Now, it's a lot cheaper."

Like Lipitor, simvastatin is a "statin" drug and essentially does the same thing: lowers the lipid profile of non-HDL cholesterol.

High cholesterol can lead to arteriosclerosis, which can lead to strokes and heart attacks.

Also known by its brand names Xanax and Niravam, alprazolam is an anti-anxiety medication.

It belongs to a group of drugs called benzodiazepines that slow down the movement of chemicals in the brain that may become unbalanced. This results in a reduction in anxiety.

Alprazolam is used to treat anxiety disorders, panic disorders and anxiety caused by depression.

Megan Williams: 540/374-5000, ext. 5661mewilliams@freelancestar.com

117,200,000

1. Hydrocodone

61,704,000

2. Lisinopril

55,122,000

3. Lipitor

52, 987,000

4. Amoxicillin

49,677,000

5. Levothyroxine

45,777,000

6. Hydrochlorothiazide

45,279,000

7. Azithromycin

42,180,000

8. Atenolol

41,496,000

9. Simvastatin

40,914,000

10. Alprazolam