The FDA has expanded the Emergency Use Authorizations (EUAs) for the mRNA COVID-19 vaccines manufactured by Pfizer-BioNTech (Comirnaty) and Moderna (Spikevax) to allow for their use as a second booster dose ≥4 months after a first booster dose in adults ≥50 years old and in persons aged ≥12 years (Pfizer) or ≥18 years (Moderna) who have undergone solid organ transplantation or have a condition that compromises the immune system to a similar extent.

The FDA has approved Crexont (Amneal), an extended-release capsule formulation of carbidopa/levodopa, for treatment of Parkinson's disease (PD), postencephalitic parkinsonism, and parkinsonism associated with carbon monoxide or manganese intoxication. Crexont contains a combination of immediate-release carbidopa/levodopa granules and extended-release levodopa pellets. An extended-release carbidopa/levodopa oral capsule (Rytary) has been available from the same manufacturer for years; the patent for Rytary expires in 2025.

The goal of asthma treatment is to control symptoms, prevent exacerbations, and maintain normal lung function. Management of acute exacerbations in the emergency department is not discussed here.

A vaccine to prevent hepatitis A (Havrix - SmithKline Beecham), previously licensed in more than 40 countries, including Canada, is now available in the United States. A similar vaccine manufactured by Merck is investigational in the USA.

An inhalation aerosol formulation of the corticosteroid fluticasone propionate (Flovent -Glaxo Wellcome) has been approved by the US Food and Drug Administration for maintenance treatment of asthma.

Private cord blood banks continue to advertise their services to couples expecting a child. Cord blood can be stored safely for many years. Public cord blood banks accept collections only from affiliated hospitals (Medical Letter 2001; 43:84). Units are available for any patient; there is no guarantee that a particular donor's blood will be available if the donor or a family member needs a stem cell transplant. Many patients can find an unrelated match in a public cord blood bank, but members of minority ethnic groups are often more difficult to match (www.marrow.org). Private cord blood banks...

The FDA has approved Duexis (Horizon), a fixed-dose combination of the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen and the H2-receptor antagonist (H2RA) famotidine, for symptomatic relief of osteoarthritis and rheumatoid arthritis and to decrease the risk of developing gastric and duodenal ulcers in patients at risk for NSAID-associated ulcers. Vimovo, a combination of the NSAID naproxen and the proton pump inhibitor (PPI) esomeprazole, is also approved by the FDA for prevention of NSAID-associated gastric ulcers.

The FDA has approved deferiprone (de fer’ i prone; Ferriprox – ApoPharma), an oral chelating agent available in Europe since 1999, for use as a second-line treatment of iron overload due to blood transfusions (transfusional hemosiderosis) in patients with thalassemia. Two other iron chelating agents, deferoxamine (Desferal, and others), which is usually administered subcutaneously, and oral deferasirox (Exjade), are available for use as first-line therapy in the US.

The FDA has approved the antiparasitic drug ivermectin in a 0.5% lotion (Sklice – Sanofi Pasteur) as a single-use topical treatment for head lice in patients ≥6 months old. Oral ivermectin (Stromectol – Merck) is effective for treatment of head lice resistant to other therapies, but it has not been approved by the FDA for this indication.

With the widespread adoption of the CHA₂DS₂-VASc scoring system, oral anticoagulation therapy is now recommended for all patients ≥75 years old with nonvalvular atrial fibrillation. Atrial fibrillation has, however, been associated with an increased risk of falls, and older patients starting warfarin for atrial fibrillation have a high rate of hospitalization for intracranial bleeding. Many practitioners are reluctant, therefore, to prescribe an oral anticoagulant for elderly patients who are at high risk for falls.