What drugs are doctors allowed to prescribe?

Michael Jackson may have received a dangerous anesthetic drug, propofol (Diprivan), prior to his death and toxicology reports that would prove this are still pending. Officials are now saying that propofol was found in his home and that Jackson may have been using the drug as a sleeping aid for up to two years. It has also been reported that the drug was administered by his physician, Dr. Conrad Murray, the day that Mr. Jackson died. There are no FDA indications for propofol as a sleeping aid. This raises the question of what drugs can be legally prescribed by doctors? It may surprise you to know that doctors can prescribe drugs for anything they see fit because the FDA does not regulate the practice of medicine. Individual states do this through their professional licensing laws and processes.

FDA refers to the U.S. Food and Drug Administration, the branch of the Department of Health and Human Services (DHHS) that approves drugs for marketing and sales. An FDA indication is the disease or condition for which a particular drug is approved to treat. Drug manufacturers are not allowed to market drugs for indications that are not FDA approved. However, once drugs are on the market, physicians may legally prescribe and administer FDA-approved drugs for any disease or condition and indeed such off label use is extremely common (see book links below). Off label use does not imply that a drug is either unsafe or ineffective for a non-approved use. It is up to the individual doctor to understand the latest medical information and their own qualifications and experience when giving any drug. Improper use is usually a retrospective judgment that is made in the context of medical ethics, malpractice laws or criminal laws.

So is it a good idea to use a drug like propofol (Diprivan) as a sleeping aid? Here are the actual FDA recommendations for indications, usage and warnings for propofol. An excerpt from this document follows:
“For general anesthesia or monitored anesthesia care (MAC) sedation, DIPRIVAN Injectable Emulsion [propofol] should be administered only by persons trained in the administration of general anesthesia and not involved in the conduct of the surgical/diagnostic procedure. Sedated patients should be continuously monitored, and facilities for maintenance of a patent [open] airway, providing artificial ventilation [breathing], administering supplemental oxygen, and instituting cardiovascular resuscitation must be immediately available. Patients should be continuously monitored…”

rs.propofol

[AMAZONPRODUCT=B000GCFCWI] [AMAZONPRODUCT=0743286715]

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

1 Comment

  1. Khairul

    November 16, 2012 at 4:26 pm

    I don’t believe Dr. Murry shluod have been jailed, license taken away, yes, but not jailed. There are alot of people who are responsible for MJ’s demise starting all the way back to his childhood. To just pin this all on one man when many could have stepped in long ago to help MJ’s out is just absurd. What about the family? They new for years of all the trouble MJ was going thru, all the addictions he had. Did anyone of them ever try to get him help? U want to throw someone in jail then lets start with the father, Mr. Joe Jackson. He is the one that attributed to alot of Michaels problems as an adult. So many people aided and abetted Michael as far as his addictions. I am among many who loved Michael, but I am sorry, Michael is partially responsible for his own demise as well. So to label Dr. Murray as the man who killed Michael Jackson is too me, just a little bit harsh.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Real Time Analytics Google Analytics Alternative