Thursday, October 24, 2013

Back to updates - Mefloquine, Quinolones, New anticoagulants (Box warnings)

It's time to catch up with more drug news after more than half a year of Marketing study instead of Pharmacy study. @.@

Black Box in the Nutshell...

Mefloquine
- it is an anti-malarial medicine which can be purchased directly from the pharmacy


The FDA is advising the public about strengthened and updated warnings regarding neurologic and psychiatric side effects associated with the antimalarial drug mefloquine hydrochloride. The neurologic side effects can include dizziness, loss of balance, or ringing in the ears.  The psychiatric side effects can include feeling anxious, mistrustful, depressed, or having hallucinations.

Neurologic side effects can occur at any time during drug use, and can last for months to years after the drug is stopped or can be permanent.  Patients, caregivers, and health care professionals should watch for these side effects. When using the drug to prevent malaria, if a patient develops neurologic or psychiatric symptoms, mefloquine should be stopped, and an alternate medicine should be used.  If a patient develops neurologic or psychiatric symptoms while on mefloquine, the patient should contact the prescribing health care professional.  Source: http://www.fda.gov/drugs/drugsafety/ucm362227.htm


Quinolone antibiotics
- most side effects are CNS effects, tendonitis, blood sugar changes, and QT prolongation
- quinolone-related nerve damage is very rare but it can persist for a long time even after stopping the antibiotic
- to let doctor know if patients develop peripheral neuropathy such as pain, burning, numbness, etc.


New anticoagulants: Dabigatran, Rivaroxaban, Apixaban
- Increased stroke risk in patients with Atrial Fibrillation if therapy is discontinued due to their shorter half-lives (so their blood thinning effect wears off faster)
- Important to emphasize patient compliance

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