pharmaceutical

Watch Your Diabetic Medications

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Risk of cardiovascular disease and all cause mortality among patients with type 2 diabetes prescribed oral antidiabetes drugs: retrospective cohort study using UK general practice research database — Tzoulaki et al. 339: b4731 — BMJ

Conclusions Our findings suggest a relatively unfavourable risk profile of sulphonylureas compared with metformin for all outcomes examined. Pioglitazone was associated with reduced all cause mortality compared with metformin. Pioglitazone also had a favourable risk profile compared with rosiglitazone; although this requires replication in other studies, it may have implications for prescribing within this class of drugs.

Ziprasidone (Geodon) – Think Bipolar

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Medical News: Ziprasidone Okayed for Bipolar Disorder – in Psychiatry, Bipolar Disorder from MedPage Today

Ziprasidone comes with a long list of precautions and contraindications:

 

* It should not be used in patients with a known history of QT prolongation, recent acute myocardial infarction, or uncompensated heart failure, and should not be used with other QT-prolonging drugs.
* It should also be avoided in elderly patients with dementia-related psychosis, as studies have shown that ziprasidone increases the risk of death in such patients.
* Discontinuation should be considered in patients showing signs of tardive dyskinesia.
* Treatment should be stopped immediately in patients with symptoms of neuroleptic malignant syndrome, which include hyperpyrexia, muscle rigidity, diaphoresis, tachycardia, irregular pulse or blood pressure, cardiac dysrhythmia, and altered mental status.
* Patients and clinicians should be alert for hyperglycemia, rash, seizures, and orthostatic hypotension with ziprasidone.