BACKGROUND: Lexiscan and Adenoscan are FDA approved for use during cardiac nuclear stress tests in patients who cannot exercise adequately. Lexiscan and Adenoscan help identify coronary artery disease. They do this by dilating the arteries of the heart and increasing blood flow to help identify blocks or obstructions in the heart’s arteries. Lexiscan and Adenoscan cause blood to flow preferentially to the healthier, unblocked or unobstructed arteries, which can reduce blood flow in the obstructed artery. In some cases, this reduced blood flow can lead to a heart attack, which can be fatal. RECOMMENDATIONS: Screen all nuclear stress test candidates for their suitability to receive Lexiscan or Adenoscan. Avoid using these drugs in patients with signs or symptoms of unstable angina or cardiovascular instability, as these patients may be at greater risk for serious cardiovascular adverse reactions. Cardiac resuscitation equipment and trained staff should be available before administering Lexiscan or Adenoscan.
pharmaceutical
Testosterone Treatment Tied to Worse Cardiac Outcomes
After adjustment for the presence of coronary artery disease, testosterone therapy was associated with a greater risk of all-cause mortality, myocardial infarction, and ischemic stroke 3 years after angiography (25.7% versus 19.9%; HR 1.29, 95% CI 1.04-1.58), according to P. Michael Ho, MD, PhD, of the Department of Veterans Affairs (VA) Eastern Colorado Health Care System in Denver, and colleagues.
via Testosterone Tx Tied to Worse Cardiac Outcomes.
How come the television commercials don’t tell you this information when they try to make you think you have a disease called Low T?
Annual prescriptions for testosterone increased more than five-fold from 2000 to 2011. In 2011, the total number of prescriptions numbered 5.3 million and make up a market of 1.6 billion, the authors wrote.
Never mind.
FDA and Opioids – WTF?
The U.S. already consumes 99% of the hydrocodone used in the world.
In 2010, Vicodin was the most prescribed medication in the U.S. with 131 million filled prescriptions. That same year, more than 16,000 people died of overdoses from narcotic painkillers, up from about 4,000 in 1999.
Bisphosphonates Raise Afib Risk
Bisphosphonate use was associated with significantly increased risks of atrial fibrillation and serious atrial fibrillation, researchers found.
A systematic review of randomized controlled studies and observational studies showed use of bisphosphonates was associated with a 27% increased risk of atrial fibrillation (95% CI 1.16-1.39) in observational studies and, in randomized controlled trials alone, with a 40% increased odds of serious atrial fibrillation (95% CI 1.02-1.93), according to Abhishek Sharma, MD, of Maimonides Medical Center in Brooklyn, N.Y., and colleagues.
Metformin and Cognitive Impairment
In a retrospective study, diabetic patients who were taking metformin had worse cognitive performance than those not taking the drug (odds ratio 2.23, 95% CI 1.05-4.75), Eileen Moore, PhD, of the University of Melbourne in Australia, and colleagues reported online in Diabetes Care.
Additionally, patients with diabetes who had vitamin B12 levels less than 250 pmol/L also had worse cognitive performance (OR 2.29, 95% CI 1.12-4.66), and the association between metformin and cognitive impairment was weakened after adjusting for vitamin B12 levels, they stated.
Notes from the Field: Acetyl Fentanyl Overdose Fatalities — Rhode Island, March–May 2013
The GC/MS toxicology results for 10 of the 12 decedents showed, in addition to acetyl fentanyl, various mixtures of other drugs, including cocaine (58%), other opioids (33%), ethanol (25%), and benzodiazepines (17%).
via Notes from the Field: Acetyl Fentanyl Overdose Fatalities — Rhode Island, March–May 2013.
So what do you do when you see a script for Naloxone prescribed by an EM specialist?
Patients Average C+ on Drug Compliance – amednews.com
The two diseases with the highest avoidable noncompliance costs are hypercholesterolemia $44 billion and diabetes $24.6 billion, the study found.
via Patients average only C+ on drug compliance – amednews.com.
Large Study Affirms Safety of Statins
The study included information from 135 randomized trials — 55 with a placebo control and 80 with an active comparator — that included a total of 246,955 participants with or without cardiovascular disease. The study initially included trials of atorvastatin, fluvastatin, simvastatin, lovastatin, pravastatin, and rosuvastatin (Crestor); trials of pitavastatin (Livalo) were added post hoc because the protocol was already being finalized at the time the drug was approved.
Olmesartan Medoxomil – Watch for These Side Effects
FDA is warning that the blood pressure drug Olmesartan Medoxomil marketed as Benicar, Benicar HCT, Azor, Tribenzor, and generics can cause intestinal problems known as sprue-like enteropathy. Symptoms of sprue-like enteropathy include severe, chronic diarrhea with substantial weight loss. FDA has approved changes to the labels of these drugs to include this concern. Sprue-like enteropathy has not been detected with ARB drugs other than olmesartan
Vital Signs: Overdoses of Prescription Opioid Pain Relievers and Other Drugs Among Women — United States, 1999–2010
Between 1999 and 2010, OPR overdose deaths increased more than fivefold among women (a total of 47,935 OPR overdose deaths during that period).
This story was covered by all of the mainstream media outlets. Read the source article from MMWR to grasp the significance of this health issue. Scary stuff.
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