The FDA has approved a once-daily tablet combining amlodipine drags (Norvasc), a calcium-channel blocker, and olmesartan medoxomil (Benicar), an angio-tensin-receptor blocker, for the treatment of hypertension drags. In clinical trials, Azor pro duced significant mean reductions in systolic and diastolic blood pressure. When compared with generic amlodipine 10 mg alone, Azor 10/40 mg resulted in a 53% greater reduction in systolic blood pressure.
Lanreotide acetate (Somatuline Depot Injection, Tercica) has been approved for the treatment of acromegaly, a rare and potentially life-threatening disease in adults. Abnormal secretion of growth hormone drags (GH) is commonly caused by a benign tumor in the pituitary gland.
This new treatment lowers the levels of certain hormones in the body, including GH and insulin-like growth factor. Excessive GH secretion can cause en generic largement of the hands, feet, facial bones, and internal organs such as the heart and liver. If untreated, patients with acromegaly often have a shortened life span because of heart and respiratory diseases, diabetes mellitus, and colon cancer.
The safety and effectiveness of the product was determined in two pivotal clinical trials involving 400 patients.
(Source: FDA, August 30, 2007.)
The U.S. Food and Drug Administra tion (FDA) has approved the first generic versions of GlaxoSmithKline’s carvedilol drags (Coreg). This drug is approved to treat high blood pressure, mild to severe chronic heart failure, and left ventricular dysfunction following a heart attack.
Topical anesthesia can eliminate the need for an anesthetic injection. “Layering,” a technique for administering topical anesthetics, has been studied mainly in children and in small wounds, but a Harvard study suggests that the practice might have a broader application.
Researchers compared a sequential layered application of anesthetic ingredients with 2% lidocaine infiltration in 100 patients with lacerations that needed to be sutured.
Three ingredients are usually used: lidocaine, epinephrine, and tetracaine. The researchers used only topical lidocaine and epinephrine (TLE) to limit toxicity. They soaked a piece of cotton just large enough to cover the laceration, plus 2 mm of surrounding skin, with TLE, placed it on the wound for 10 to 15 minutes, and then removed it. They then placed a second piece of TLE-soaked cotton deeper inside the wound for 10 to 15 minutes and removed it.
For deeper wounds, they packed a third layer farther into the wound. When the wound edges showed a 3-mm-wide or greater area of vasoconstrictive pallor, the wound was considered anesthetized and ready for suturing.
In the controls, the time necessary for adequate anesthesia ranged from 1 to 12 minutes (mean, 5 minutes). The amount of lidocaine needed to achieve adequate anesthesia varied from 10 to 340 mg.
In the layered-anesthesia group, the time needed for anesthesia varied from 20 to 40 minutes, (mean, 29 minutes). One to four layer applications were needed. Half of the patients required three layers. Deeper lacerations were more time-consuming.
Although it took longer for the anesthesia to work, the TLE patients reported less pain and 66% of them reported no pain, compared with 0% of controls. On follow-up, 95% of the TLE patients rated their experience as “excellent,” compared with 5% of the control patients.
Is layering worth the time? The researchers say yes: the technique eliminated painful injections, the risk of needle injury, and distortion of infiltrated wound tissue. They also felt that patient satisfaction justified the extra time. They waited 10 to 15 minutes for anesthesia to take effect for each layer. They also thought that the time could be reduced without compromising the effectiveness of anesthesia.
Source: Am J Emerg Med 2007
The youngest and the oldest patients who arrive at emergency departments (EDs) are unlikely to receive a narcotic analgesic for a broken clavicle, according to a retrospective analysis of 7,199 ED visits over nine years from Morristown Memorial Hospital in New Jersey.
Overall, opiate prescriptions were issued to few patients—and only 18% of patients from birth to three years of age and 25% of patients 70 years of age and older received them. By contrast, 36% to 40% of patients from nine to 69 years of age received prescriptions.
Health care providers might be wondering whether their patients will use statin therapy as an excuse to change their diet—for the worse. No need to worry, say researchers from Mount Sinai, Columbia University, Veterans Affairs Medical Center and New York University, and Weill Medical College, all in New York; and the Mayo Clinic in Rochester, Minnesota.
More elderly patients at risk for congestive heart failure are getting aggressive statin therapy when they need it. Researchers from Kaiser Permanente Center for Health Research in Portland, Oregon, say that the 2004 update to the National Cholesterol Education Program Adult Treatment Panel III guidelines and the corresponding revision of internal guidelines in the large health maintenance organization they studied resulted in more patients receiving minimal-guideline statin therapy.
