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.

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The FDA has announced that the prescribing information for haloperidol (Haldol, generic versions) has been revised to include a new cardiovascular subsection in the Warnings section.

Life-threatening generic arrhythmias (e.g., sudden death, QT prolongation, torsades de pointes) have been reported in patients treated with haloperidol, especially when the drug is administered intravenously or at doses higher than recommended.

Injectable haloperidol is approved only for intramuscular injection, although IV administration is known to be a fairly common off-label clinical practice. A minimum of 28 cases of QT prolongation and torsades de pointes have been reported following intravenous administration, and some have resulted in death.

(Sources: FDA)

Important revisions have been made to the Contraindications, Warnings, and Dosage and Administration sections of the full prescribing information for ceftriaxone (Rocephin, Roche).

This new information addresses the interaction of ceftriaxone with calcium-containing products based on reports of fatal cases in neonates. Although no cases of ceftriaxone-calcium precipitates in patients other than neonates have been reported, the potential for this interaction exists in patients of any age.

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For the first time in a decade, the National Asthma Education and Prevention Program has updated clinical guidelines for the diagnosis and management of asthma. New features include:
• an expanded section on asthma for children 5 to 11 years of age.
• information on medications.
• recommendations for patient education other than in a physician’s office.
• advice for controlling environmental factors that can cause symptoms of asthma.

The guidelines reaffirm that patients with persistent asthma need both long-term control and quick-relief medications. Also included are new recommendations:
• inhaled corticosteroids: considered the most effective long-term control medication for all age groups.
• leukotriene receptor antagonists and cromolyn: for long-term control.
• long-acting beta agonists: as adjunct therapy with inhaled corticosteroids.
• omalizumab (Xolair, Genentech): for severe asthma.
• albuterol, levalbuterol, and corticosteroids: for acute exacerbations.

(Source: National Heart, Lung, and Blood Institute, August 29, 2007.)

A patient’s age isn’t necessarily a good reason to not try a sirolimus-eluting stent, according to a German study of 6,755 patients.

The sirolimus stents resulted in “an impressive relief of angina,” the researchers reported. In-hospital (1%) and six-month (4%) mortality rates, as expected, were higher in patients older than 75 years of age.

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The Centers for Disease Control and Prevention (CDC) reports that nearly 19,000 people died in the U.S. in 2005 after being infected a virulent drug resistant bacterium, methicillin-resistant Staphylococcus aureus (MRSA). The number of deaths associated with MRSA exceeds those attributed to AIDS, Parkinson’s disease, emphysema, and homicide each year.

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The FDA has granted marketing approval of Genzyme’s sevelamer carbonate (Renvela) for the control of serum phosphorus in patients with chronic kidney disease drug on dialysis.

Renvela is considered to be an improved version of Renagel (sevelamer HCl), a common phosphate binder.

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