Medicines and the Digestive System

IBS Treatment and Prevention

Medicines and the Digestive System | Johns Hopkins Medicine

Dietary changes, medications, and psychotherapy can help alleviate IBS symptoms.

To better control your IBS, consider making certain diet and lifestyle changes. Depending on your symptoms, it might help to go gluten free, cut back on rich foods, take medication, or try an alternative remedy such as peppermint.

Irritable bowel syndrome (IBS) can involve a number of different symptoms, including abdominal pain, cramping, gas, diarrhea, and constipation. (1)

Treatments for IBS are geared toward relieving the symptoms of this gastrointestinal disorder and improving your quality of life. The course of treatment that you and your healthcare provider choose will depend on the type and severity of your symptoms.

It’s important to try to develop a good sense of how your IBS is affected by your diet, stress, and any other factors in your life. By paying attention to these factors, you and your doctor can better determine what might be needed to improve your symptoms.

It’s also important to freely share information about your symptoms with your doctor. Good communication is key: You both should feel comfortable asking and answering questions about your condition. According to Johns Hopkins Medicine, people with IBS who report better relationships with their doctor also tend to report better symptom control. (2)

Treatments for IBS fall into a few broad categories:

  • Dietary changes
  • Medications
  • Psychotherapy (talk therapy)
  • Alternative remedies

Depending on your symptoms, any combination of these options may be part of your treatment strategy.

Once you find a successful strategy for managing your IBS, you may find that it’s possible to take a less intensive approach that’s geared toward preventing, rather than reducing, your symptoms. (1,2)

Mild cases of IBS can often be controlled by:

  • Avoiding trigger foods
  • Increasing your fiber intake, which can relieve constipation
  • Exercising more
  • Getting enough sleep
  • Drinking enough fluids
  • Avoiding stressful situations (1,3)

If these simple steps aren’t enough to control your symptoms, a number of dietary changes may be worth considering.

Dietary Strategies for Managing IBS Symptoms

Dietary changes are usually the first line of treatment for IBS. There isn’t one single formula for changing your diet — instead, the approach should be your symptoms and any food-related triggers that you notice.

Avoid gas-producing foods. If bloating and gas are problems for you, it may help to avoid items carbonated beverages, caffeine, raw fruits, and cruciferous vegetables cabbage, broccoli, and cauliflower. Though increasing your fiber intake is recommended, go slow when adding foods high in fiber to your diet — too much too soon can cause gas, triggering IBS symptoms. (3)

Cut back on rich foods. Particularly if your symptoms include diarrhea, you may benefit from reducing your intake of fatty foods, which can stimulate contractions in your colon. Caffeine can do the same thing, so reducing your intake can also improve diarrhea.

Go gluten-free. If diarrhea is a problem, you may benefit from cutting out foods that contain gluten, a protein found in wheat, barley, and rye.

Avoid FODMAPs.

 Some people with IBS respond to cutting out FODMAPs, an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols — certain carbohydrates that aren’t well digested in your small intestine. This group includes fructose, lactose, fructans, and sugar alcohols.

You may need to work with a dietitian or nutritionist to drastically reduce FODMAPs in your diet, then gradually reintroduce foods to see if they cause symptoms. (1,2)

Supplements and Medications for IBS Relief

Medications typically aren’t the first line of treatment for IBS, but they may be helpful for people with moderate to severe symptoms who have tried different dietary strategies without success.

Depending on your symptoms, your doctor may prescribe one or more of the following:

Fiber supplements If increasing fiber in your diet isn’t effective, you can take a variety of supplements containing different forms of fiber. This is particularly geared toward people who experience constipation.

Laxatives If fiber supplements don’t effectively relieve constipation, the next step is often to try a drug that stimulates bowel movements.

Smooth muscle relaxants These drugs can help with intestinal cramping, abdominal pain, and bouts of diarrhea. In some cases, though, they may cause constipation.

Antidiarrheal drugs If you experience frequent diarrhea, it may help to take a drug, such as Imodium (loperamide), that slows down the movement of contents through your intestine or improves the consistency of your stools. (4)

Antidepressants Even if you don’t experience depression — but especially if you do — your doctor may prescribe certain categories of antidepressants (tricyclic or selective serotonin reuptake inhibitors) to reduce pain or diarrhea by acting on your nervous system. People without depression are usually given a low dose of these drugs.

Pain relievers Certain drugs that act on the brain’s pain sensory mechanisms can help ease severe abdominal pain or bloating.

Antibiotics If your doctor suspects that an imbalance of gut bacteria is responsible for your symptoms, you may take drugs designed to kill off certain strains of bacteria. The goal is to let healthy bacteria flourish, not to wipe out all of them.

IBS-specific drugs A number of drugs are designed to treat specific symptoms of IBS. These include: Lotronex (alosetron), Viberzi (eluxadoline), Xifaxan (rifaximin), Amitiza (lubiprostone), and Linzess (linaclotide). (1,2)

The Benefits of Talking With a Therapist for IBS

For many people with IBS, emotional stress is an important factor in how frequent and severe their symptoms are.

It’s important to have a discussion with your doctor about how stress might be contributing to your symptoms. If you both agree that stress, anxiety, or depression could be affecting your IBS, you may be referred to a mental health professional.

When you see a therapist, the following strategies may be used to help improve your symptoms.

Cognitive behavioral therapy This type of talk therapy focuses on helping you change your patterns of thought and behavior. Years of research support its effectiveness as a treatment for IBS.

Gut-directed hypnotherapy For this treatment, your therapist puts you in a trance- state to help you relax and focus in an effort to improve your symptoms.

Relaxation training Your therapist may guide you through strategies to relax or to reduce the impact of stressful events or thoughts on your body. (2,3)

Alternative and Complementary Remedies to Consider

The evidence in favor of various alternative therapies for IBS is mixed. Talk to your doctor before trying any of the following treatments.

Probiotics Certain probiotics may help control IBS symptoms abdominal pain, bloating, and diarrhea. (1) What works for you will depend on your symptoms and the unique makeup of your gut bacteria.

Acupuncture This traditional Chinese medicine practice involves inserting very fine needles into specific areas of the body, and it may help treat anxiety associated with IBS or even potentially have a direct effect on your digestive action.

Peppermint Because it can help relax the smooth muscles in your intestines, peppermint may provide short-term symptom relief. Several studies suggest that peppermint oil capsules may help with symptoms of IBS. (5)

Meditative practices Activities that relax or focus your mind and body, yoga and meditation, can help relieve stress. Certain therapeutic massage practices may have a similar effect. (1,2)

Source: https://www.everydayhealth.com/digestive-health/ibs/treatment-medications-for-ibs.aspx

RA and Gastrointestinal Problems

Medicines and the Digestive System | Johns Hopkins Medicine

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Medicines and the Digestive System

Medicines and the Digestive System | Johns Hopkins Medicine

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Medicines taken by mouth can affect the digestive system in a number of different ways. Both prescription and over-the-counter medicines, while usually safe and effective, may create harmful effects in some people.

Certain medicines taken together may interact and cause harmful side effects.

In addition, it is important that your healthcare providers know about any allergies, sensitivities, as well as other medical conditions you have before taking a new medicine.

People with food intolerance, such as gluten intolerance, must be sure medicines do not contain fillers or additives with these substances.

Listed below are some problems related to the digestive system that can happen when taking medicine:

Irritation of the esophagusTips to prevent irritation of the esophagusAbout esophageal refluxTips to avoid reflux
Some people have difficulty swallowing tablets or capsules, or sometimes take medicines without liquid. Tablets or capsules that stay in the esophagus may release chemicals that can irritate the lining of the esophagus. This may cause ulcers, bleeding, perforation, and narrowing (strictures) of the esophagus. The risk of these types of injuries is greater in persons with medical conditions involving the esophagus, including the following:
  • Strictures (narrowing of the esophagus)
  • Scleroderma (hardening of the skin)
  • Achalasia (irregular muscle activity of the esophagus, which delays passage of food)
  • Stroke

Certain medicines can also cause ulcers in the esophagus when they become lodged there. These include aspirin, certain antibiotics, quinidine, potassium chloride, vitamin C, and iron.

  • Stand or sit when swallowing medicines.
  • Take several swallows of liquid before taking the medicine, and swallow the medicine with a full 8 oz. glass of liquid.
  • Do not lie down immediately after taking medicine, to make sure the pills have gone through the esophagus into the stomach.
  • Notify your healthcare provider if you experience painful swallowing or feel that the medicine is sticking in your throat.
Some medicines interfere with the action of the sphincter muscle, located between the esophagus and stomach. This muscle allows the passage of food into the stomach after swallowing. This can increase the chances of reflux, or backup of the stomach's acidic contents into the esophagus.Classes of medicines that may increase the severity of reflux include the following:
  • Nonsteroidal anti-inflammatory agents (NSAIDs)
  • Nitrates
  • Theophylline
  • Calcium channel blockers
  • Oral antibiotics
  • Birth control pills
  • Avoid coffee, alcohol, chocolate, and fatty or fried foods, which may worsen reflux.
  • Quit, or reduce, smoking.
  • Do not lie down right after eating.
Irritation of the stomachTips to prevent irritation of the stomach One of the most common irritants to the lining of the stomach is that caused by nonsteroidal anti-inflammatory drugs (NSAIDs). This includes medicines, such as ibuprofen and other common pain relievers. These medicines weaken the ability of the lining to resist acid made in the stomach and can sometimes lead to inflammation of the stomach lining (gastritis), ulcers, bleeding, or perforation of the lining.Older people are at greater risk for irritation from these medicines because they are more ly to take these pain relievers for chronic conditions. People with a history of peptic ulcers and gastritis are also at risk.
  • Take coated tablets, which may reduce irritation.
  • Do not drink alcoholic beverages when taking these medicines.
  • Take medicines with food, or with a full glass of milk or water, which may reduce irritation.
ConstipationTips to prevent constipation A variety of medicines can cause constipation. This happens because these medicines affect the nerve and muscle activity in the colon (large intestine), resulting in the slow and difficult passage of stool.Medicines that may cause constipation include the following:

  • Antihypertensives
  • Anticholinergics
  • Cholestyramine
  • Iron
  • Antacids containing mostly aluminum
  • Narcotics/pain medicines
  • Eat a well-balanced diet including fruits, vegetables, and whole grains.
  • Drink plenty of fluids.
  • Exercise regularly.
  • Discuss taking a laxative or stool softener with your healthcare provider.
DiarrheaTips to prevent diarrhea Diarrhea is most often caused by antibiotics, which affect bacteria normally present in the large intestine. These changes in intestinal bacteria allow the overgrowth of the bacteria Clostridium difficile (C. difficile), which causes a more serious antibiotic-induced diarrhea. The presence of this bacteria can cause colitis, resulting in very loose, watery stools. The most common antibiotics to cause this type of diarrhea include the following:
  • Penicillin, including ampicillin and amoxicillin
  • Clindamycin
  • Cephalosporins

This colitis is usually treated with another antibiotic that acts on the C. difficile. Certain medicines may also alter the movements or fluid content of the colon without causing colitis. Colchicine and magnesium-containing antacids can both cause diarrhea.Talk with your healthcare provider if the diarrhea persists for several days.

  • Usually, preventing diarrhea involves avoiding foods known to irritate your stomach.
  • Treatment usually involves replacing lost fluids, and may include antibiotics when bacterial infections are the cause.
  • Eating foods that are high in lactose bacillus, such as yogurt, acidophilus milk/pills, or cottage cheese, helps to replenish the normal bacteria present in the large intestine.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/medicines-and-the-digestive-system

Seasonal Digestive Distress: 10 Tips for Coping

Medicines and the Digestive System | Johns Hopkins Medicine

From the WebMD Archives

End of summer and early fall is a time for barbecue, seaside clambakes, and fair food. And unless we’re careful, we suffer some unpleasant results: stomachaches, nausea, heartburn, and constipation or diarrhea.

Outdoor events can trigger digestive problems in a number of ways:

  • Picnic and party food can spoil in the heat.
  • We may over-exercise.
  • And it’s easy to become dehydrated.

What can you do? Here, gastroenterologists offer five ways to avoid digestive problems, followed by five ways to deal with digestive trouble once you have it.

1. Eat Smaller, Frequent Meals. If you want to prevent indigestion, eat smaller, more frequent meals, writes gastroenterologist Cynthia M. Yoshida, MD, in her book No More Digestive Problems. In the case of a great picnic or barbecue, try starting with small portions of your favorite foods.

2. Take It Slow. Taste your food, savor it, and space it out. Practice mindful eating, and talk and socialize, says Gerard E.

Mullin, MD, associate professor of medicine and director of integrative GI nutrition services at the Johns Hopkins Hospital.

“If you overwhelm your stomach — and the more you eat the more you slow it down — you'll feel gas, bloating and discomfort.” Here’s one good way to help yourself slow down: Cut your food into small pieces, then chew each piece well.

Going slow refers to physical activity, too. Mullin suggests that if you exercise for more than 45 minutes, wait an hour before you eat so that the blood diverted to your muscles has time to return to your stomach, where it's needed to help digest your food.

3. Store Food Safely. The waning sun feels great on your skin, but it also allows bacteria to thrive on food. There are about 76 million cases of food-borne illness in the U.S. each year, says the CDC. Common symptoms are diarrhea, vomiting, and other digestive problems.

Keep cold foods cold, hot foods hot, and if you have doubts about that salad, steak, or picnic bounty, pass it up. Hot foods should be kept at 140 degrees or warmer. Cold foods should be kept at 40 degrees or colder. Perishable food should not be kept at room temperature for longer than two hours.

4. Avoid Fried and Acidic Foods. To prevent gas, bloating, and other symptoms of overindulgence, limit or avoid these types of food:

  • Fatty food, fried foods and cheese, which take longer to digest and increase risk for heartburn
  • Gassy foods, sodas and beans
  • Acidic foods, citrus, tomatoes, colas, tea, and coffee, which can lead to heartburn

5. Hydrate. When it's warm out, you want to be sure you're getting enough fluids. Yet you don't want to gulp down glass after glass, which can cause you to swallow air, leading to bloating and gas. Dehydration can lead to constipation and nausea. Drink sensibly before you're thirsty.

You got caught up in the fun and overdid it at the barbecue anyway? Have no fear, it's not hard to handle occasional digestive problems.

1. Eat Fruits and Herbs That Soothe the Stomach. Certain foods can help a troubled digestion, says Mullin, who favors pineapple, papaya, ginger tea, and fennel. Other experts also recommend chamomile to soothe stomachs.

2. Drink Clear Liquids. If your digestive problems include diarrhea or vomiting, it's even more important to remain hydrated, though you should take it slow. Drink clear liquids one teaspoon at a time until you can keep them down. Hold off on solid foods for several hours.

If you've got a bad stomachache, severe abdominal pain, or persistent diarrhea or vomiting accompanied by fever, see your doctor right away.

3. Avoid Strong Odors. If too much food has made you queasy, you might want to step away from the grill — and your favorite aunt who wears all the perfume. Strong odors cooking smells, perfumes, colognes, and smoke can overturn a queasy stomach.

4. Stay Away From Substances That Irritate Stomachs. Coffee, alcohol, and carbonated beverages can aggravate the digestive system. So can some over-the-counter and prescription medications, as well as some herbal remedies and supplements. If you take medication or supplements and have digestive trouble, talk with your doctor.

5. Try Over-the-Counter (OTC) Remedies. Antacids and acid blockers may help relieve occasional indigestion when you've overindulged, while antidiarrheal drugs may help with diarrhea. To be sure you're taking the right medication for your symptoms, talk to your doctor.

“Self-diagnosis and drugs of any kind make a bad combination,” writes Steven R. Peikin MD, professor of medicine and head of the division of gastroenterology and liver diseases at Cooper University Hospital, in his book Gastrointestinal Health.Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), for example, can make gastrointestinal issues worse for some.

Fortunately stomachaches, diarrhea, constipation, and other digestive problems are usually fleeting.

If you experience digestive trouble often, talk to your health care provider. Your symptoms may be related to a medical condition such as acid reflux, food intolerance, inflammatory bowel disease, irritable bowel syndrome, or ulcers. It may also be related to medications or supplements you are taking.

If you have frequent diarrhea, the CDC recommends seeing your doctor if you've also got:

  • High fever (temperature over 101.5 degrees, measured orally)
  • Blood in your stool
  • Prolonged vomiting that prevents keeping liquids down (which can lead to dehydration)
  • Signs of dehydration, including a decrease in urination, a dry mouth and throat, and feeling dizzy when standing up
  • Diarrheal illness that lasts more than 3 days

But for most people who have a bit of digestive distress after we overindulge, a little rest, time, and TLC should be all we need to get through occasional barbecue excess.

SOURCES: 

Gerard E. Mullin, MD, associate professor of medicine, director of integrative GI nutrition services, Johns Hopkins Hospital.

Yoshida, Cynthia M. No More Digestive Problems, Bantam Books, 2004.

CDC: “Foodborne Illness: Frequently Asked Questions.”

National Institutes of Health, Medline Plus: “Abdominal Pain.”

USDA: “Handling Food Safely.”

Peikin, Steven R. Gastrointestinal Health, Harper Perennial, 1999.

National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health: “Indigestion.”

WebMD Feature: “Adventures in Vomiting,” “Anxiety, Stress, and Stomachaches.”

KidsHealth.org: “How to Be Safe When You're in the Sun.”

© 2010 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/digestive-disorders/features/seasonal-digestion-problems

From our collaborators at Johns Hopkins Medicine International | Bothered by constipation?

Medicines and the Digestive System | Johns Hopkins Medicine
Posted August 19, 2016By Linda Lee, M.D., Director of the Johns Hopkins Integrative Medicine and Digestive Center

Tummy symptoms can be uncomfortable and sometimes painful.

Do you feel gassy, bloated or constipated? Are they affecting your quality of life or work productivity? If you answered yes, you are not alone. In the United States, where I’m based, related symptoms account for more than 2.

5 million doctor’s office visits a year.

These symptoms can be signs of a less-than-healthy colon. Understanding them can help you reduce the risk of preventable diseases irritable bowel syndrome, diverticulitis and colon cancer. Read on and learn how to deal with them.

Are you experiencing gas and bloating in your gut?

Some of the gas in your gut is from air or carbonated beverages you have swallowed. Additionally, bacteria in your colon produces intestinal gas by fermenting certain carbohydrates found in your diet. Although bacterial production of intestinal gas is normal, gas accumulation may make you feel bloated.

This feeling of fullness is mostly tied to what you eat, and it might be worsened by constipation. Strategies to reduce gas and bloating include reducing your intake of foods that lead to gassiness, treating constipation, and consuming lactose-free foods and foods that contain probiotics, which are live bacteria that are good for your digestive system.

Some excellent sources of probiotics include yogurt, pickles and dark chocolate.

What is constipation?

When you have fewer than three bowel movements per week, you may be constipated. Up to 20 percent of Americans suffer from this, and women are more often affected than men.

When constipated, your stools can be pebbly and dry, and you may have to strain to complete a movement. Pain and bloating may be associated. Causes for constipation can include change in diet, decreased physical activity, medication side effects or colon blockage.

How can you care for your colon and avoid constipation?

The colon, aka the large intestine, is part of your digestive system. It is home to trillions of micro-organisms that help your immune system develop normally. The colon’s job is to absorb water and nutrients from the stool.

To avoid constipation and maintain a healthy colon, you should watch what you eat, include at least 25 grams of fiber in your daily diet, drink lots of water and exercise. You can also review your medications with your doctor, who can prescribe laxatives, if necessary.

When should you worry about your constipation?

You should check with your doctor if there is blood in your stool, or if you have abdominal pain, weight loss or have been found to have a low blood count (anemia). Furthermore, excessive straining over many years due to constipation can cause hemorrhoids or stretch your pelvic floor muscles, making it even more difficult in the future.

Are you at risk for colorectal cancer?

The World Health Organization lists colorectal cancer as one of the deadliest forms of cancer. The chances of getting colorectal cancer are one in 19, yet it is highly curable when detected early.

Risk factors include age—most who suffer are over 50—family history of colorectal cancer and polyps, and personal history of polyps and inflammatory bowel disease.

Lifestyle factors that may increase your risk for colorectal cancer include a diet high in red or processed meats, and/or one low in fresh fruits and vegetables. Obesity, physical inactivity, heavy alcohol consumption and smoking increase the risk.

Colorectal cancer screening should begin at age 50, but you should start earlier if you have other risk factors. A colonoscopy is recommended at least once every 10 years. Other screening methods include a virtual colonoscopy—a CT scan that re-creates 3-D images of the colon—and stool DNA tests. You should discuss the different options with your doctor.

Content courtesy of Linda Lee, M.D., director of the Johns Hopkins Integrative Medicine and Digestive Center and clinical director of the Division of Gastroenterology and Hepatology at the Johns Hopkins University School of Medicine.

The content was reproduced with permission of the office of Marketing and Communications for Johns Hopkins Medicine International. Additional reuse and reprinting is not allowed.

The information aims to educate readers and is not a substitute for consultation with a physician.

Source: http://www.medcan.com/medcan-insights/health-tips-advice/johns-hopkins-medicine-bothered-constipation/

Jeremy A. Greene, MD, PhD

Medicines and the Digestive System | Johns Hopkins Medicine

Twentieth century clinical medicine;  pharmaceuticals; medical technology; medical anthropology; global health; history of disease.

I am broadly interested in the history of disease, and my research explores the ways in which medical technologies come to influence our understandings of what it means to be sick or healthy, normal or abnormal. 

My most recent book, Generic: The Unbranding of Modern Medicine, narrates the history of generic drugs as a means of exploring problems of similarity and difference in modern medicine.   Generic drugs are never fully identical to the brand name products they imitate.

  Rather, their claims to being ‘the same’ lies in proof that they are similar enough in ways that matter to be functionally interchangeable.

As the market for generic substitutes has grown–from only 10% of the American pharmaceutical market in 1960 to nearly 80% by 2010–so too have epistemological and epidemiological conflicts over how one can prove that generics are truly equivalent to their brand-name counterparts.

   These debates over generic drugs reveal fundamental conflicts over what it means to practice rational medicine, and what role consumers, physicians, insurers, and others should have in defining that rationality.

My current project, The Electronic Patient   examines how changing expectations of instantaneous communications through electric, electronic, and digital media transformed the nature of medical practice and medical knowledge.

 This research is focused on recapturing how seemningly mundane communications technologies have enabled and altered the production, circulation, and consumption of medical knowledge, from telegraph to text pager, telephone to telemedicine, fax machine to .

  This work has been supported by a  Faculty Scholars Fellowship from the Greenwall Foundation and a G13 Award from the National Library of Medicine.

My broader research interests focus on the history of disease, medical technology, the history of global health, and the relationship between medicine and the marketplace.

I received my MD and PhD in the history of science from Harvard in 2005, completed a residency in Internal Medicine at the Brigham & Women’s Hospital in 2008, and am board certified in Internal Medicine and a member of the American College of Physicians.

In addition to my appointment at the Institute for the History of Medicine, I also practice internal medicine at the East Baltimore Medical Center, a community health center affiliated with Johns Hopkins.

Selected Books

Greene JA, Condreau F, and Watkins ES (eds.) Therapeutic Revolutions: Pharmaceuticals and Social Change in the 20th Century.  Chicago: University of Chicago Press, 2016 (in press).

Greene JA.  Generic: The Unbranding of Modern Medicine. Baltimore: Johns Hopkins University Press, 2014.

Greene JA and Watkins, ES. (eds.) Prescribed: Writing, Filling, Using, and Abusing Prescriptions in Modern America. Baltimore, 2012.

Greene JA. Prescribing by Numbers: Drugs and the Definition of Disease. Baltimore: Johns Hopkins University Press, 2007.

Selected Articles

Bothwell, L, Greene JA, Podolsky SH, Jones DS.  Assessing the gold standard: Lessons from the history of RCTs.  NEJM 2016:374:2175-81.

Greene JA. Do-it-yourself medical devices: Technology and empowerment in American health care.  NEJM 2016; 374: 305-9.

Greene JA, Riggs KR. Why is there no generic insulin? Historical origins of a modern problem.  New England Journal of Medicine 2015; 372:1171-1175.

Jones DS, Greene JA, Duffin J, Harley Warner J.  Making the case for history in medical education. Journal of the History of Medicine and Allied Sciences; 70(1):2015 (e-publication ahead of print).

Greene JA. The materiality of the brand: Form, function, and the pharmaceutical trademark.  History and Technology 2013; 29(2):210-226.

Jones DS, Podolsky SH, Greene JA.  The burden of disease and the changing task of medicine.  New England Journal of Medicine 2012; 366(25):233-8.

Greene JA. What’s in a name?  Generics and the persistence of the pharmaceutical brand in American medicine. Journal of the History of Medicine & Allied Sciences 2011; 66(4): 425-467.

Greene JA and Kesselheim AS.  Why do the same drugs look different?  Pills, trade dress, and public health. The New England Journal of Medicine 2011; 365(1):83-89.

Greene JA. Making medicines essential: the evolving role of pharmaceuticals in global health. BioSocieties 2011; 6:10-33.

Greene JA and Podolsky SH. Keeping modern in medicine: pharmaceutical promotion and physician education in postwar America. Bulletin of the History of Medicine 2009; 83: 331-377.

Chapters

Greene JA. “Pharmaceutical Geographies: Mapping the Boundaries of the Therapeutic Revolution”. in Greene JA, Condrau F, and Watkins ES.  Therapeutic Revolutions. Chicago, Univ Chicago Press  (in press, 2016).

Greene JA. “The Afterlife of the Prescription: Sciences of Therapeutic Surveillance” in Greene, Jeremy A. and Watkins, Elizabeth S. (eds.) Prescribed: Writing, Filling, Using, and Abusing Prescriptions in Modern America. Baltimore: Johns Hopkins University Press, 2012.

Greene JA. “Regulating Drugs, Regulating Disease: Diabetes, Consumerism, and the Tolbutamide Crisis, 1969-1984” in Jean-Paul Gaudilliere and Volker Hess (eds.), Making Drugs: Ways of Regulating in Factories, Laboratories, and Consulting Rooms. London: Palgrave Macmillan, 2011: 122-136.

Daemmrich A and Greene JA.  “From Visible Harm to Relative Risk: Overcoming Fragmented Pharmacovigilance,” in Elhage, E. (ed.), The Fragmentation of U.S. Health Care: Causes and Solutions.  Oxford, UK: Oxford University Press, 2010. 301-323.

Greene JA. “The Abnormal and the Pathological: Cholesterol, Statins, and the Threshold of Disease” in Andrea Tone and Elizabeth Watkins (eds.), Medicating Modern America: Pharmaceutical Drugs in History. New York: New York University Press, 2007; 183-228.

Broadcast media (selected)

1.     NPR: Marketplace: “The Future of the Pharmaceutical Sales Rep” 17 December 2013, http://www.marketplace.org/topics/health-care/future-pharmaceutical-sales-rep

2.     NPR: Science Friday: “The Science of Sameness: Developing Generic Medications” 12 September 2014, http://www.sciencefriday.com/segment/09/12/2014/the-science-of-sameness-developing-generic-medications.html

3.     WYPR: Morning Edition with Sheilah Kast: “Generic: The Unbranding of Modern Medicine” 22 September 2014, http://wypr.org/post/generic-unbranding-modern-medicine

4.     NPR: The People’s Pharmacy “The Pros and Cons of Generic Drugs” 13 December 2014, http://www.peoplespharmacy.com/2014/12/11/show-973-the-pros-and-cons-of-generic-drugs/

5.     WAMU: The Kojo Nmandi Show: “Generic: The Unbranding of Modern Medicine” 23 December 2014, http://thekojonnamdishow.org/shows/2014-12-23/generic_the_unbranding_of_modern_medicine

6.     WPR: Central Time: “A Cultural History of Generic Drugs in America”, 30 September 2014, 31 December 2014, http://www.wpr.org/cultural-history-generic-drugs-america

7.     NPR: Shots: “Why is Insulin So Expensive in the U.S.?”  19 March, 2015, http://www.npr.org/sections/health-shots/2015/03/19/393856788/why-is-u-s-insulin-so-expensive

8.     WNYC: The Leonard Lopate Show: “Similar How? The Cultural and Political Fights for Generic Drugs” 20 March 2015, http://www.wnyc.org/story/jeremy-greene-generic/

9.     NPR: Morning Edition: “20 Years After Its Discovery, No Generic Insulin Sold in the U.S.”  22 March 2015, http://www.npr.org/2015/03/22/394634923/90-years-after-its-discovery-no-generic-insulin-sold-in-the-u-s

10.  WPR: Central Time, “Record $374 Billion Spent on Prescription Drugs in America Last Year” 14 April 2015; http://www.wpr.org/record-374-billion-spent-prescription-drugs-america-last-year

11.  WGBH: Innovation Hub: “The Power of Generic Drugs” 9 July 2015, http://blogs.wgbh.org/innovation-hub/2015/7/9/greene-generics/

Teaching

Course Director, Scholarly Concentrations (History of Medicine)

SOM150.714 Outline of History of Modern Medicine

AS.140.668.01 Technologyin Context

AS150.702 History of Modern Medicine

SOM 150.816: Biomedicine: History, Concepts, Practices

FPHE Selective: Introduction to Social Medicine

Genes to Society: Workshop Leader in Pulmonary, GI, Reproductive Blocks

AS140.877.01: Directed Reading and Research

Source: https://hopkinshistoryofmedicine.org/content/jeremy-greene