Pharmacy & Therapeutics- July 2008 - (Page 388) NEW DRUGS (Haldol); loxapine (Loxitane); thioridazine (Mellaril); molindone (Moban); thiothixene (Navane); pimozide (Orap); fluphenazine (Prolixin); trifluoperazine (Stelazine); chlorpromazine (Thorazine); and perphenazine (Trilafon). The atypical drugs include aripiprazole (Abilify); clozapine (Clozaril); clozapine (FazaClo); ziprasidone (Geodon); paliperidone (Invega); risperidone (Risperdal); quetiapine (Seroquel); olanzapine (Zyprexa); and olanzapine with fluoxetine (Symbyax). (Source: FDA, June 17, 2008.) DRUG NEWS patients undergoing percutaneous coronary intervention (PCI) may be able to reduce the risk of death and ischemic complications. However, its use has been debated for patients who are receiving a glycoprotein IIb/IIIa inhibitor (GPI), because both drugs are associated with a higher risk of bleeding. A meta-analysis of three trials (PCICURE, CREDO, and PCI-CLARITY) involving 6,325 patients found a “consistent benefit,” according to researchers from Brigham and Women’s Hospital and Harvard Medical School, University of Kentucky, McMaster University, and University of Edinburgh. Overall, pretreatment reduced the odds of cardiovascular death, MI, or stroke after PCI by roughly 29% in both groups, whether or not the patients were receiving a GPI. Moreover, clopidogrel pretreatment was not associated with significantly more major or minor bleeding in either group. (Source: Am Heart J 2008;155:910– 917.) Becaplermin (Regranex Gel) For Leg and Foot Ulcers A boxed war ning about a risk of cancer is being added to the labeling for becaplermin (Regranex Gel 0.01%, Ortho-McNeil) when patients use three or more tubes of the product. This topical agent is used by diabetic patients to treat leg and foot ulcers that are not healing. As a recombinant form of human platelet-derived growth factor, the gel is applied directly to the ulcer. Growth factors cause cells to divide more rapidly. For this reason, the manufacturer continued to monitor studies that began before the product’s approval in December 1997 for any evidence of adverse effects, such as an increase in cancer. (Source: FDA, June 9, 2008, www.fda. gov; www.medicalnewstoday.com) pletion of the earth’s ozone layer. Three HFA-propelled albuterol inhalers have been approved: ProAir, Proventil, and Ventolin Aerosol. Another HFA-propelled inhaler containing levalbuterol is also available as Xopenex Aerosol. Manufacturers have been increasing production of HFA albuterol inhalers, and adequate supplies are available. Albuterol inhalers are used to treat bronchospasm in patients with asthma and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. The spray of an HFA-propelled albuterol inhaler may feel softer than that of the CFC type. Patients must clean HFA-propelled albuterol inhalers to prevent the buildup of the drug in the device. (Source: FDA, June 4, 2008.) Pain Relief: Ice Water or Ethyl Chloride? The lowly ice cube may be better than the vapocoolant ethyl chloride spray in controlling pain induced by an antibiotic skin test. Researchers from Korea compared the two treatments in a randomized study. Fifty healthy volunteers received an intradermal skin test on both arms. Only one volunteer considered the spray a more effective analgesic than the ice, and seven participants noted no difference in pain. The 42 others said ice pretreatment was better as analgesia, although 32 volunteers said that the ice cube was more uncomfortable than the spray. Nonetheless, nearly all—45 volunteers—preferred the ice. (Source: Am J Emerg Med 2008;26: 59–61.) Disulfiram (Antabuse) Yields Success In Alcohol Dependence Alcohol-dependent patients went 54 days longer without a relapse when they were treated with disulfiram (Antabuse, Odyssey), compared with patients receiving topiramate (Topamax, OrthoMcNeil). In a study from Mumbai, India, 90% of 50 patients receiving disulfiram were still abstinent from alcohol at nine months, compared with 56% of 50 patients receiving topiramate. Nausea was more common with disulfiram than with topiramate (4% vs. 1%), but the side effects abated in the first two weeks. The topiramate patients also had lower alcohol-craving scores. The researchers say supportive families might have kept the dropout rate low, and they emphasized that treatment works best when patients are supervised New Inhalers Required For Asthma and COPD The FDA has alerted patients, caregivers, and health care professionals to switch to hydrofluoroalkane (HFA)propelled albuterol inhalers. Chloro fluorocarbon (CFC)-propelled inhalers are being phased out and will not be available in the U.S. after December 31, 2008. The CFC type is considered harmful to the environment by contributing to de- Clopidogrel (Plavix) Safe With Glycoprotein Inhibitors Pretreatment with clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis) for 388 P&T® • July 2008 • Vol. 33 No. 7 http://www.fda http://www.medicalnewstoday.com
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