Internal Medicine Alert – January 15, 2006

January 15, 2006

• Pharmacology Watch

  FDA Recommends Approval of Muraglitazar, But May Need To Reconsider; Which Antipsychotics Are More Dangerous?; Should CPOE Undergo Evaluation?; New Treatment for Tennis Elbow; FDA Actions

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• Is it Better to Prescribe a Cyclooxygenase-2 Inhibitor or Conventional NSAIDs to Prevent Adverse Gastrointestinal Events?

  Cyclooxygenase 2 (COX 2) inhibitors may not be as safe as previously thought. These agents have a considerable risk of adverse gastrointestinal events. The concurrent use of ulcer-healing drugs appears to decrease this risk.

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• Lamotrigine for Migraine with Aura

  The strong correlation between reduction of aura symptoms and migraine attacks stresses the potential role of aura-like events and possibly cortical spreading depression as a trigger for trigeminal vascular activation, and subsequently the development of migraine headaches.

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• Frequent Fliers

  A very small group of patients consume a significant portion of outpatient primary care physician time.

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• Infliximab for Induction and Maintenance Therapy for Ulcerative Colitis

  Infliximab, an antibody against tumor necrosis factor, is effective in ulcerative colitis.

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• Pharmacology Update: Mecasermin Injection (Increlex™)

  A new drug has been approved for the treatment of children with below average height who are resistant to growth hormone. Mecasermin is a human insulin-like growth factor-1 (IGF-1) that is produced by recombinant DNA technology. This protein is marketed by Tercica, Incorporated as Increlex.

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• Clinical Briefs By Louis Kuritzky, MD

  Risk of Death in Elderly Users of Conventional vs Atypical Antipsychotic Medications; Beta-Blockers to Prevent Gastroesophageal Varices in Cirrhosis Patients; Effects of Protein, Monounsaturated Fat, and Carbohydrate Intake on Blood Pressure and Serum Lipids

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• ECG Review: Abnormal ECG in a 35-Year-Old Man

  The ECG in the Figure was obtained from a 35-year-old man. Is it abnormal? What do you want to know

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