PharmaceuticalPreparations

Last year the Cochrane team, with the help of the BMJ’s open data campaign, finally got access to full clinical study reports on neuraminidase inhibitors. Tom Jefferson and Peter Doshi explain what the new systematic review found and how a series of failures meant that decisions about these drugs were made without the full evidence  

The patient is a 63 year old freelance editor with type 2 diabetes diagnosed about five years ago that is relatively well controlled with insulin. He has early signs of retinopathy, with normal kidney function and electrocardiogram. Lipid values are normal with diet and atorvastatin 20 mg/day. He developed autonomic and peripheral neuropathy a few months ago, and now experiences postural hypotension and burning pain and clumsiness in his feet. His pain makes concentration and falling asleep difficult. He asks his general practitioner for painkillers to help him continue working.  

Sales of monoclonal antibodies are projected to reach more than $160bn in the US alone over the next few years so is it any wonder that drug companies fiercely protect their profits? Allen Shaughnessy considers why these unique and complex drugs are so eyewateringly expensive  

Last year the Cochrane team, with the help of the BMJ’s open data campaign, finally got access to full clinical study reports on neuraminidase inhibitors. Tom Jefferson and Peter Doshi explain what the new systematic review found and how a series of failures meant that decisions about these drugs were made without the full evidence  

Researchers assessed the effectiveness of “n-of-1” trials for the short term choice of drugs for osteoarthritis. The efficacy of sustained release paracetamol was compared with celecoxib in the management of symptoms associated with osteoarthritis. A series of double blind randomised n-of-1 controlled trials using a double dummy design was performed. The intervention was sustained release paracetamol (two 665 mg tablets, three times a day), or celecoxib (200 mg daily, or 200 mg twice a day for those who were already using this dose). Each treatment regimen was taken for two weeks, administered for three treatment cycles. The primary outcome measures included pain, stiffness, and functional limitation scores; preferred treatment; and adverse effects.1  

A course of ketamine delivered intravenously could potentially be used to treat severe depression in patients who do not respond to other drugs, a UK study has found.  

A 28 year old woman presented with a raised, red and intensely itchy rash on the extensor surface of her elbows and buttocks, in groups of small blisters. There was no history of trauma, atopy, or recent illness. She had no gastrointestinal symptoms or change in bowel habit and had not lost weight. No major medical or surgical history was noted and she was not taking drugs on a regular basis. Owing to the appearance and location of the rash, together with pruritus, dermatitis herpetiformis was suspected.  

A 78 year old man presented with an eight week history of left sided abdominal pain and back pain, associated with anorexia, 3 kg weight loss, and night sweats. He was previously well, had no medical history of note, was taking no regular drugs, and was an ex-smoker.  

Researchers assessed the effectiveness of “n-of-1” trials for the short term choice of drugs for osteoarthritis. The efficacy of sustained release paracetamol was compared with celecoxib in the management of symptoms associated with osteoarthritis. A series of double blind randomised n-of-1 controlled trials using a double dummy design was performed. The intervention was sustained release paracetamol (two 665 mg tablets, three times a day), or celecoxib (200 mg daily, or 200 mg twice a day for those who were already using this dose). Each treatment regimen was taken for two weeks, administered for three treatment cycles. The primary outcome measures included pain, stiffness, and functional limitation scores; preferred treatment; and adverse effects.1  

Large quantities of anti-psychotic drugs are being given to people with learning disabilities who are resident in hospitals or care homes.  

Naked Scientists - 27th Aug 2011 - Drugs from the Sea, and Thalidomide at 50  

Naked Scientists - 21st Nov 2010 - Smart Pills: Drugs to Boost Brain Power  

Crime minister Norman Baker says "all options" are being considered on the problem of legal highs, after the Home Office ruled out licensing of shops.  

Widespread resistance to antimicrobial drugs is not a future threat—it is happening now in hospitals and in the community, a report from the World Health Organization warns.1  

In clear and accessible language, Professor David Nutt’s Drugs Without the Hot Air argues the case for an evidence-based approach, challenging elements of drug policy and myths on the relative harms of legal and illegal drugs.  

Two in three deaths from asthma could be prevented by better management of the condition including personal asthma plans for patients, timely reviews of asthma care, and the prescription of more appropriate drugs, says the first confidential inquiry into asthma by the Royal College of Physicians.1