1
Drugs That May Cause Psychiatric Symptoms
The Medical Letter on Drugs and Therapeutics • December 15, 2008; (Issue 1301)
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.
Click here to view the free full article.
Click here to view the free full article.
2
In Brief: Higher-Dose Semaglutide (Ozempic) for Type 2 Diabetes
The Medical Letter on Drugs and Therapeutics • May 16, 2022; (Issue 1650)
The FDA has approved a higher-dose injectable
formulation of the long-acting glucagon-like
peptide-1 (GLP-1) receptor agonist semaglutide
(Ozempic) for treatment of type 2 diabetes in adults.
A single SC injection of the new 8 mg/3 mL
formulation delivers 2 mg of semaglutide.
3
Adult Immunization
The Medical Letter on Drugs and Therapeutics • May 7, 2018; (Issue 1546)
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.
4
Drug Interactions
The Medical Letter on Drugs and Therapeutics • June 8, 2003; (Issue 1158)
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.
5
Addendum: Dexlansoprazole for GERD
The Medical Letter on Drugs and Therapeutics • May 16, 2022; (Issue 1650)
A reader commented that our recent article on
Drugs for GERD and Peptic Ulcer Disease did not
include enough information on dexlansoprazole
(Dexilant, and generics), a proton pump inhibitor
(PPI) claimed to provide "all-day and all-night relief
from heartburn". Dexlansoprazole recently became
available generically, but it is much more expensive
than other generic PPIs.
6
Drugs for Hypertension
The Medical Letter on Drugs and Therapeutics • May 18, 2020; (Issue 1598)
Drugs available for treatment of chronic hypertension
and their dosages, adverse effects, and costs are
listed in the tables. Treatment
of hypertensive urgencies and emergencies is not
discussed here.
7
Paxlovid for Treatment of COVID-19
The Medical Letter on Drugs and Therapeutics • January 24, 2022; (Issue 1642)
On December 22, 2021, the FDA issued an Emergency
Use Authorization (EUA) for the investigational
antiviral drug nirmatrelvir copackaged with the HIV-1
protease inhibitor ritonavir (Paxlovid – Pfizer) for
oral treatment of mild to moderate COVID-19 in
outpatients ≥12 years old who weigh at least 40 kg
and are at high risk of progressing to severe disease,
including hospitalization or death. Paxlovid was the
first oral antiviral drug to be authorized in the US for
treatment of COVID-19; Merck's oral antiviral drug
molnupiravir was granted an EUA for treatment of
COVID-19 on December 23, 2021. The
IV antiviral drug remdesivir (Veklury) was approved
by the FDA in 2020 for treatment of COVID-19 in
hospitalized patients.
8
In Brief: Fexofenadine (Allegra) and Fruit Juice
The Medical Letter on Drugs and Therapeutics • May 30, 2011; (Issue 1365)
Fexofenadine (Allegra, and others) is the most recent second-generation H1-antihistamine to become available over the counter (OTC). Cetirizine (Zyrtec, and others) and loratadine (Claritin, and others) are already available OTC. Cetirizine can be sedating in usual doses. Loratadine can be sedating in higher-than-usual doses. Fexofenadine remains nonsedating even in higher doses.
9
In Brief: OTC Alcaftadine (Lastacaft Once Daily Relief) for Allergic Conjunctivitis
The Medical Letter on Drugs and Therapeutics • May 16, 2022; (Issue 1650)
The ophthalmic H1-antihistamine alcaftadine 0.25%,
which has been available by prescription since 2011
for use in patients with allergic conjunctivitis, is now
available without a prescription as Lastacaft Once
Daily Relief (Allergan) for temporary relief of itchy eyes
due to pollen, ragweed, grass, animal hair, and dander
in adults and children ≥2 years old. It is the third
ophthalmic antihistamine to be approved for over-the-counter
(OTC) use (see Table 1).
10
Drugs for Common Bacterial Infections in Adults
The Medical Letter on Drugs and Therapeutics • October 23, 2017; (Issue 1532)
Bacterial infections in adults are generally treated
empirically, with the antibiotic covering most, but not
all, of the potential causative pathogens. For some
infections, culture and sensitivity testing can guide
treatment, allowing for use of narrower-spectrum
antibiotics. The recommended dosages and durations
of antibiotic treatment for common respiratory, skin, and
urinary tract infections are listed in Tables 1-3. Infectious
disease experts now recommend shorter treatment
durations for many infections to reduce the development
of antimicrobial resistance and minimize adverse effects.