Archive for 'Pharmacology' Category

Commentary: Regulation of Energy Drinks

Amelia M. Arria, PhD & Mary Claire O’Brien, MD offer their opinion on energy drink regulation in JAMA In this Commentary, we outline why regular (nonalcoholic) energy drinks might pose just as great a threat to individual and public health and safety. Energy drinks are beverages that contain modest to relatively high levels and concentrations [...]

Propoxyphene (Darvocet) Withdrawn

Citing risk of serious or fatal arrhythmias, the US Food and Drug Administration (FDA) has asked that propoxyphene, (brand names Darvon and Darvocet, Xanodyne Pharmaceuticals) be removed from the US market. Propoxyphene is an opioid typically used to treat mild to moderate pain. It was first approved by the FDA in 1957. It is sold [...]

Novel Immunogenic Cocaine Vaccine Shows Promise in Murine Model

In their study, published Jan. 4 in the online edition of Molecular Therapy…this novel strategy might be the first to offer cocaine addicts a fairly simple way to break and reverse their habit, and it might also be useful in treating other addictions, such as to nicotine [or] opiates. the study’s lead investigator, Dr. Ronald [...]

Identifying the Red Flags of SSRI Therapy

One physician’s approach to limiting the adverse reactions to antidepressant medications: PCPs must watch for at least the following clues to determine, post hoc, which patients might be hurt by antidepressants: Patient has a dramatic response (my rule of thumb: be very concerned if the patient is 50% better in less than 4 weeks or [...]

Guide to QT Prolongation & Torsades de Pointes – Drugs of Risk

The University of Arizona Center for Education and Research on Therapeutics provides a handy list of medications associated with Torsades de Pointes, a ventricular tachyarrhythmia often seen in the setting of hypokalemia, hypomagnesemia, hypocalcemia, diarrhea, or alcoholism. Torsades has the dangerous potential for degeneration into ventricular fibrillation and is treated with magnesium sulfate infusion and, [...]

The Association between Proton Pump Inhibitors and C. Difficile

investigators conducted a secondary analysis of prospectively collected data from 101,796 patients who were discharged from a tertiary care medical center during a 5-year period. Acid suppression treatment was the primary exposure of interest, classified by intensity (no acid suppression, histamine2-receptor antagonist [H2RA] treatment, daily PPI use, and PPI use more often than daily). The [...]

Sipuleucel-T (Provenge), The First FDA-Approved Cancer "Vaccine" – What Every Medical Student Should Know

Here are the bare bones facts on Provenge. A basic understanding will help you to stand out when the discussion inevitably comes up. Drug Name: Sipuleucel-T Trade Name: Provenge Trial Name: APC 8015 Manufacturer: Dendreon Corporation Class: autologous, dendritic cell-based immunotherapy Indication: hormone-refractory, metastatic prostate cancer MOA: Induces patient’s own cells to attack prostate cancer. [...]

Rheumatology Pearls

A positive ANCA is meaningless if the patient’s illness doesn’t resemble Wegener’s, MPA or RPGN. Septic arthritis—11% mortality. Underappreciated complications of immunosuppressive therapy: Corticosteroids — infectious complications Anti-TNFs & Rituximab — Heb B flare, acute liver failure. Azathiaprine — hypersensitivity syndrome. Hospital Medicine 2010 April 9 sessions—rheumatology pearls [Notes from Dr. RW]

Pharm Friday – Antiplatelet Agents Overview

Another home run from our friends at Pharmamotion: Classification: ADP Antagonists: thienopyridines act by inhibiting the ADP-dependent pathway of platelet activation. These drugs have no direct effect on prostaglandin metabolism. Ticlopidine …is approved for secondary prevention of thrombotic strokes in patients intolerant of aspirin and for prevention of stent thrombosis in combination with aspirin. adverse [...]

Generic Versus Branded Drugs: Concerns Amidst Limited Evidence

Many physicians have found [the switch to generic drugs] particularly problematic in classes of drugs with a narrow therapeutic range, including antiepileptics, psychotropics, antiarrhythmics, and anticoagulants. although the generic’s mean maximal concentration and area under the concentration-time curve are typically within a few percentage points of the original’s — typically about 4% — the 90% [...]