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Drugs Today – July 2008


Phenytoin’s effect on bone loss         
Premenopausal women who take phenytoin (Dilantin) may experience a significant short-term increase in bone loss. In a 1-year observational study, the rate of bone loss in those taking phenytoin was more than eight times higher than the typical rate for healthy women of the same age. The study also indicates that other major anticonvulsants—carbamazepine (Tegretol), lamotrigine (Lamictal), and valproate (Depakene)—don’t produce this adverse effect.

Recall of dietary supplements          
Herbal Science International, Inc. is recalling 12 dietary supplements that contain ephedra, aristolochic acid, or human placenta because they may present serious health hazards to consumers. The Food and Drug Administration (FDA) regards ephedra as a potential health hazard because it raises blood pressure and otherwise stresses the circulatory system—effects linked to myocardial infarction and stroke. Aristolochic acid is a potent carcinogen and a nephrotoxin linked to kidney failure. And human placenta, an ingredient that may transmit disease, can’t be marketed lawfully in the United States.

Ozone-friendly inhalers  
Patients with asthma face a mandatory transition from inhalers with chlorofluorocarbons (CFCs) to ones with ozone-friendly hydrofluoroalkanes (HFAs). The new HFA inhalers, which patients must start using by January 1, 2009:
•      must be pumped four times before use
•      need to be cleaned weekly
•      have a weaker spray than CFC inhalers
•      require a slower inhalation than CFC inhalers
•      cost about three times more than CFC inhalers.
The four available HFA inhalers are Ventolin, ProAir, Proventil, and Xopenex.

Fainting from vaccine shots      
Since the Centers for Disease Control and Prevention recommended three vaccines in 2005 and 2006, reports of syncope after vaccine shots have sharply increased. The vaccines are meningococcal conjugate vaccine (MCV4); tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap); and human papillomavirus (HPV) vaccine. Most of the patients who fainted were girls ages 11 to 18.

Amitiza: First drug for IBS with constipation        
The FDA has approved lubiprostone (Amitiza) to treat irritable bowel syndrome with constipation (IBS-C) in women ages 18 and older, making it the first drug available in the United States to treat the disabling condition. Patients should take the drug twice a day in 8-microgram doses with food and water. Common adverse effects include nausea, diarrhea, and abdominal pain.

The views and opinions expressed here are those of the author and do not necessarily reflect the opinions or recommendations of the American Nurses Association, the Editorial Advisory Board members, or the Publisher, Editors and staff of American Nurse Journal. This has not been peer reviewed.

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