Healthcare Traveler - January 2009 - (Page 38)

Drug Update Drug approved for Huntington’s disease T H E L AT E S T D E V E LO PM EN T S I N R E SE A RCH OTC Talk Three generations of antihistamines H Photo: Getty Images/Rosalind Hodgkins istamine is a chemical mediator produced by the body in response to allergens. Histamine-1 (H-1) receptors, found throughout the body, cause responses such as increased vascular permeability, like stuffy nose and watery eyes; pruritus and skin erythema; and smooth muscle contraction in the respiratory and gastrointestinal tracts. H-1 receptor blockers are divided into three “generations.” Among firstgeneration agents are diphenhydramine (Benadryl), chlorpheniramine (ChlorTrimeton), clemastine (Tavist), hydroxizine (Atarax) and promethazine (Phenergan). Because most of these “older” drugs cross the blood/brain barrier, sedation is common, and they also tend to have problematic anticholinergic actions associated with dry eyes, dry mouth, urinary retention, and constipation. Most of the second-generation antihistamines also are sold without a prescription. These include loratidine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra). These agents are as effective as older antihistamines, with few anticholinergic side effects. Third-generation antihistamines include desloratadine (Clarinex) and levocetirizine (Xyzal), available by prescription only. Sources can be found on www.RNWeb.com. JAMES M. WOOTEN, PharmD, a member of the RN editorial board, is an associate professor of medicine at the University of Missouri School of Medicine in Kansas City, MO. T Scientific American. “FDA approves first Huntington’s disease therapy.” 2008. www.sciam. com/blog/60-second-science/post.cfm?id=fdaapproves-first-huntingtons-dise-2008-08-18 (18 Aug. 2008). RN Corner Drug Update… Professional Update… Clinical Tips… 38 Healthcare Traveler January 2009 Medical News Today. “Telmisartan modestly reduces major cardiovascular events in patients unable to tolerate Ace inhibitors (Transcend Study).” 2008. www.medicalnewstoday.com/articles/ 119745.php (31 Aug. 2008). 38 39 40 This department originally appeared in RN, a sister publication. For subscription information, call 800-284-8945 or visit www.rnweb.com. www.healthcaretraveler.com Photo: Getty Images/Thomas Northcut he FDA has approved tetrabenazine (Xenazine) as the first-ever treatment for Huntington’s disease. Tetrabenazine was originally developed in the 1950s to treat symptoms of psychosis, but has been found to be safe and effective in treating chorea, the involuntary, spastic body movements that occur in 90% of Huntington’s disease patients. According to a 2006 study by researchers at the University of Rochester Medical Center, Rochester, New York, chorea was reduced in 54 patients by an average of 25%. Researchers warn that tetrabenazine can heighten depression and cause body stiffness in some patients, but many individuals have been able to return to normal activity after years of being homebound. New option for vascular disease, diabetes A recent study indicates that angiotensin-receptor blocker telmisartan (Micardis) should be considered as a treatment option for vascular disease or highrisk diabetes in patients who cannot tolerate angiotensin-converting enzyme (ACE) inhibitors. The findings have the potential to affect 20% of patients with these diseases, who are unable to take ACE inhibitors, according to the study results published in The Lancet. The randomized, controlled trial, conducted at McMaster University in Hamilton, Ontario, analyzed 5,926 patients who had vascular disease or high-risk diabetes and were taking other proven therapies. Of these, 2,954 received telmisartan 80 mg/ day, and 2,972 received a placebo. Patients were followed up for a median term of 56 months. Researchers found that 465 (15.7%) of the telmisartan group suffered cardiovascular death, heart attack, stroke or heart failure requiring hospitalization, compared with 465 (17.0%) in the placebo group; and 894 (30.3%) of the telmisartan patients were hospitalized for cardiovascular reasons, vs. 980 (33.0%) in the placebo group. http://www.RNWeb.com http://www.sciam.com/blog/60-second-science/post.cfm?id=fdaapproves-first-huntingtons-dise-2008-08-18 http://www.sciam.com/blog/60-second-science/post.cfm?id=fdaapproves-first-huntingtons-dise-2008-08-18 http://www.sciam.com/blog/60-second-science/post.cfm?id=fdaapproves-first-huntingtons-dise-2008-08-18 http://www.medicalnewstoday.com/articles/119745.php http://www.medicalnewstoday.com/articles/119745.php http://www.rnweb.com http://www.healthcaretraveler.com

Table of Contents Feed for the Digital Edition of Healthcare Traveler - January 2009

Healthcare Traveler - January 2009 Editor’s Desk Contents By the Numbers Paws for Thought Field Notes In a Flash Med Ec-cerpts Dream Destinations Nursing from the Heart Drug Update Professional Update Clinical Tips On Assignment Cityscape Name It Advertiser’s Index Contest Rules When In… It’s in the Bag Dot.com Tax Facts Big Deals Starter’s Kit Going the Distance Allied Corner Classifieds Tales from the Road

Healthcare Traveler - January 2009

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