Saturday 27 July 2013

FDA puts strict limits on oral ketoconazole use



1.  Oral ketoconazole should never be used as first-line therapy for any fungal infection because of the risk of liver toxicity and interactions with other drugs as per FDA.

2.        Among patients presenting with an acute stroke, women were less likely than men to receive intravenous thrombolytic therapy, which could have to do with delayed arrival at the hospital. In a cohort of patients presenting within 24 hours of stroke onset, IV tissue plasminogen activator (tPA) was used in 11% of women and 14% of men (OR 0.8, 95% CI 0.7-1.0), according to Inger de Ridder, MD, of Erasmus Medical Center University Hospital in Rotterdam, and colleagues. In the subgroup of patients who presented with an acute ischemic stroke within 4 hours of symptom onset, however, the sex difference disappeared (41.6% versus 42.4%, OR 1.0, 95% CI 0.8-1.2), the researchers reported online in Stroke: Journal of the American Heart Association.

3.        There may be an early cognitive benefit for dementia patients starting on 
angiotensin-converting enzyme (ACE) inhibitors for blood pressure control. Patients taking centrally active ACE inhibitors experienced marginally slower rates of cognitive decline compared with those not on the drugs  according to William Molloy, MB, BCh, of the Centre for Gerontology and Rehabilitation at the University College Cork, St. Finbarrs' Hospital, in Cork City, Ireland, and colleagues in the online journal BMJ Open.


4.        In addition to reducing inappropriate antibiotic use and providing better infection 
control in outpatient settings, strategies to control Clostridium difficile infection (CDI) should include further examination of outpatient and household settings and a reduction in proton pump inhibitor (PPI) use, according to an article published in the July 22 issue of JAMA Internal Medicine.

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