A year in review: new drugs for older adults in 2011

BackgroundNew drugs approved by the Food and Drug Administration (FDA) may offer tremendous clinical advances by providing health care providers with new treatment strategies. However, additional care must be taken for safe and effective use of these new agents by older adults.ObjectiveOur objective was to identify FDA-approved medications in 2011 most likely to be prescribed to older adults, and to describe medication characteristics that may require special attention in this population.MethodsThe FDA Web site was reviewed for new drug approvals from January through December 2011. Approved labeling for each drug was obtained from the manufacturer's Web site and PubMed was searched for primary literature published between 1967 and 2012.ResultsRivaroxaban, an oral factor Xa inhibitor, is approved for once-daily use in treatment of nonvalvular atrial fibrillation and deep vein thrombosis prophylaxis after replacement of a hip or knee. Drug interactions and renal function must be considered when prescribing this drug to older adults. Fidaxomicin is an oral anti-infective approved for the treatment of Clostridium difficile-associated diarrhea. It has minimal oral absorption or side effects, no relevant drug interactions, but a very high cost. It is a treatment option after failure of oral metronidazole and oral vancomycin. Roflumilast is a selective inhibitor of phosphodiesterase 4 and is approved to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in patients with severe COPD and a history of exacerbations. It is recommended as a second or alternative choice combined with a long-acting bronchodilator in patients at high risk for hospitalization. Indacaterol is an inhaled long-acting β-agonist approved for COPD maintenance. It is administered once daily, which may improve adherence in older adults compared with currently available twice-daily agents.ConclusionsFour new drugs approved in 2011 applicable to the geriatric population are presented. Clinicians must consider the available evidence, cost, drug–drug interactions, renal function, pharmacokinetic/pharmacodynamic differences, and patient preferences when considering prescribing these agents to older adults.     

五倍可利洁娜霜用于女性性功能障碍（FSD）及性器官保健的研究

目的:探讨五倍可利洁娜霜对FSD中性交不适、性交疼痛的治疗及性器官保健方法.方法:对918例性交不适、性交疼痛患者采用五倍可利洁娜治疗,直接涂擦外阴皮肤、阴道口内外,一疗程(20天)后观察治疗结果,经统计处理后进行疗效分析.结果:性交不适、性交疼痛,一疗程痊愈率分别为:84.95%、78.54%;总有效率分别为:97.85%、95.75%.结论:五倍可利洁娜霜对FsD中的性交不适和性交疼痛有良好的治疗效果,特别是对因阴道干涩、性交疼痛难忍而长期终止性生活的情况,有助于性机能的恢复、重启.在应用中未发现任何毒副作用,不舍激素类成份,可广泛用于FSD中相关病症的治疗,或用于围绝经期及有性活动人群的性器官保健.     

EFFECTS OF ENFLURANE ON VISUAL EVOKED POTENTIALS IN HUMANS

Effects of enflurane on visual evoked potentials (VEP) werestudied in eight healthy female patients. Control VEP were recordedfrom the occipital electrode (O_z-C_z), and prominent negative(N70) and positive (P100) peaks were observed following flashlight stimulation. After induction of anaesthesia with thiopentone,VEP were recorded at expired concentrations of 1.2, 1.8, 2.4and 2.7% of enflurane in 100% oxygen. The amplitude of the P100was decreased and the latency of the N70 was increased significantlyfrom the control with all concentrations of enflurane. No significantdifference was found between different concentrations of enflurane.The latency of the P100 was increased significantly only atconcentrations above MAC and at 2.7% when it was significantlylonger than those at 1.2 and 1.8%. We conclude that VEP arealtered significantly with enflurane in clinically used concentrations     

Purple drank prevalence and characteristics of misusers of codeine cough syrup mixtures

A mixture of codeine cough syrup with alcohol and/or a soft drink known as “purple drank” has gained media attention in recent years as a drug associated with professional athletes and southern rap music. The existing research on purple drank consumption has primarily utilized samples of African Americans residing in the Houston, Texas area. This is the first scholarly study of purple drank use outside of the Houston, Texas area among a general population of young adults, and indicates that purple drank use is not limited to African American males. The findings depict higher odds of the use of purple drank among other racial and ethnic groups, males, and homosexual, bisexual, and transgender college students from urban areas.