The FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) will review two requests for Emergency Use Authorization (EUA) of COVID-19 vaccine candidates this month. They will review Pfizer and BioNTech's request on December 10 and Moderna's request on December 17. Both meetings will be webcast from the FDA's website and streamed on Facebook, Twitter, and YouTube.

Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.

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Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug interactions, such as vasodilation caused by both sildenafil (Viagra) and nitrates, can also have adverse effects.

The investigational neutralizing IgG1 monoclonal antibody bamlanivimab (LY-CoV555; Lilly) has been granted an FDA Emergency Use Authorization (EUA) for treatment of recently diagnosed mild to moderate COVID-19 in patients who are ≥12 years old, weigh at least 40 kg, and are at high risk for progressing to severe disease and/or hospitalization (see Table 1).

The US Advisory Committee on Immunization Practices (ACIP) recommends routine use of the following vaccines in adults residing in the US: influenza, tetanus/diphtheria alone (Td) and in combination with acellular pertussis (Tdap), measles/mumps/rubella (MMR), varicella (VAR), herpes zoster (RZV; ZVL), human papillomavirus (HPV), and pneumococcal conjugate (PCV13) and polysaccharide (PPSV23) vaccines. For adults with certain medical conditions or occupational, behavioral, or other risk factors, hepatitis A (HepA), hepatitis B (HepB), meningococcal (MenACWY; MenB), and Haemophilus influenzae type b (Hib) vaccines are also recommended. Recommendations for vaccination against seasonal influenza and vaccination of travelers are reviewed separately.

Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.

Treatment of atrial fibrillation includes anticoagulation, rate control, and rhythm control. US guidelines were recently updated.

The antiplatelet drug clopidogrel (Plavix, and others) reduces major cardiovascular events, but can cause bleeding. Proton pump inhibitors (PPIs) are often used with clopidogrel to prevent gastrointestinal bleeding, however, some evidence suggests that PPIs may interfere with the activation of clopidogrel and diminish its antiplatelet effect. FDA-approved labeling recommends avoiding concurrent use of the PPIs omeprazole and esomeprazole with clopidogrel.

View the Comparison Table: Some Parenteral Anticoagulants for VTE

Per capita spending on prescription drugs in the US is higher than in other industrialized nations, including Canada.