When Andrew Herxheimer introduced Drug and Therapeutics Bulletin (DTB) to the UK over...]]>
Overview of: Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med 2023;389:2221-32
]]>Overview of: Danbury G Susan Gladstone: Prevention of future deaths report [online], 2023. Available: https://www.judiciary. uk/prevention-of-future-death-reports/susan-gladstone-prevention-offuture-deaths-report/ [Accessed 8 January 2024].
]]>Overview of: Medicines and Healthcare products Regulatory Agency. Omega-3-acid ethyl ester medicines (Omacor/Teromeg 1000 mg capsules): dose-dependent increased risk of atrial fibrillation in patients with established cardiovascular diseases or cardiovascular risk factors. Drug Safety Update 2024;17(6):3.
]]>Overview of: Li RHW, Lo SST, Gemzell-Danielsson K, et al. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial [correction appears in Lancet. 2023;402:850]. Lancet. 2023;402:851-8.
]]>In conjunction with BMJ Case Reports, DTB will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years.
We report the first case of standard therapeutic dose paracetamol for patent ductus arteriosus closure causing acute liver failure in an extremely preterm infant. After 5 days of treatment, he presented with jaundice, acute severe hepatitis and coagulopathy. Treatment with N-acetyl cysteine resulted in full recovery.
Paracetamol is widely regarded a safe drug within the neonatal population with no reported cases of toxicity when used within standard therapeutic dosing schedules. It is increasingly used to promote patent ductus arteriosus closure in symptomatic, preterm neonates. This report highlights the...]]>
ADHD is a neurodevelopmental disorder characterised by symptoms of hyperactivity, inattention and impulsivity that interfere with daily and occupational functioning. There is no pathognomonic marker for ADHD and symptoms overlap with those of other conditions, necessitating careful diagnostic assessment. Usually evident from childhood and often persisting into adulthood, people...]]>
Overview of: Medicines and Healthcare products Regulatory Agency. Fluoroquinolone antibiotics: reminder of the risk of disabling and potentially long-lasting or irreversible side effects. Drug Safety Update 2023;17:1. Medicines and Healthcare products Regulatory Agency. Fluoroquinolone antibiotics: suicidal thoughts and behaviour. Drug Safety Update 2023;17:2.
]]>Overview of: Siraj RA, Bolton CE, McKeever TM. Association between antidepressants with pneumonia and exacerbation in patients with COPD: a self-controlled case series (SCCS). Thorax. 2023. doi:10.1136/thorax-2022-219736 [Epub ahead of print 19 June 2023]
]]>Overview of: McQuilten ZK, Thao LTP, Pasricha SR, et al. Effect of low-dose aspirin versus placebo on incidence of anemia in the elderly: a secondary analysis of the aspirin in reducing events in the elderly trial. Ann Intern Med. 2023;176:913-21.
]]>Overview of: Neligan A, Adan G, Nevitt SJ, et al. Prognosis of adults and children following a first unprovoked seizure. Cochrane Database Syst Rev. 2023:10.1002/14651858.CD013847.pub2.
]]>The rights of general practitioners (GPs) to prescribe medicines to their patients in the context of the National Health Service (NHS) in England have been well described.
In conjunction with BMJ Case Reports, DTB will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years.
The management of atopic diseases has been revolutionised by precision therapies and biological drugs that target specific immune proteins. This report elucidates a unique complication from the use of the monoclonal antibody, dupilumab, that primary care providers and subspecialists need to be aware of. A patient in her 40s consulted us for severe atopic asthma, food allergy and eczema involving the face and body. She had previously failed treatments and was started on dupilumab (which binds to the interleukin-4 [IL4] receptor and inhibits both IL-4 and IL-13). She quickly achieved remission...]]>
The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of the Parties (COP) on climate change is about to be held in Dubai while the 16th COP on biodiversity is due to be held in Turkey in 2024. The research communities that provide the evidence for the two COPs are unfortunately largely separate, but they were brought together for a workshop in 2020 when they concluded that: ‘Only by considering climate and biodiversity as parts of the same...]]>
The systematic review included 22 studies exploring the relationship between continuity of care and mortality.
Overview of:Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in severe community-acquired pneumonia. N Engl J Med 2023;388:1931–41.
]]>Overview of: Medicines and Healthcare products Regulatory Agency. Statins: very infrequent reports of myasthenia gravis.Drug Safety Update 2023;17(2):1.
]]>Overview of: Florez MA, Jaoude JA, Patel RR, et al. Incidence of primary end point changes among active cancer phase 3 randomized clinical trials.JAMA Netw Open2023;6:e2313819.
]]>In conjunction with BMJ Case Reports, DTB will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years.
Euglycaemic diabetic ketoacidosis is a serious but rare adverse effect of treatment with sodium-glucose co-transporter-2 (SGLT2) inhibitors. A man in his 60s with type 2 diabetes mellitus underwent total hip replacement for an intracapsular neck of femur fracture. His SGLT2 inhibitor was continued perioperatively and blood glucose levels were normal throughout the admission. A diagnosis of severe euglycaemic diabetic ketoacidosis was made in the operating theatre which required treatment in a critical care unit. This resulted in increased morbidity due to decreased postoperative mobilisation and a new requirement for subcutaneous insulin....]]>
There are a number of reasons for this. The development of national guidelines, such as those produced by the National Institute for Health and Care Excellence (NICE), has resulted in the adoption of clinical pathways that require monitoring of drug effect against specified targets or thresholds. Financial incentives through...]]>
Overview of: Medicines and Healthcare products Regulatory Agency. Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions. Drug Safety Update 2023;17:2.
]]>Overview of: Nissen SE, Lincoff AM, Brennan D, et al. Bempedoic acid and cardiovascular outcomes in statin-intolerant patients. N Engl J Med 2023;388:1353-64.
]]>Overview of: Vasilevskis EE, Shah AS, Hollingsworth EK, et al. deprescribing medications among older adults from end of hospitalization through postacute care: a Shed-MEDS randomized clinical trial. JAMA Intern Med 2023;183:223-31.
]]>In conjunction with BMJ Case Reports, DTB will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years.
A woman in her 60s with a history of hypertension and stasis dermatitis presented to a primary care clinic with a bilateral, erythematous rash on the legs, stomach, and chest. Photosensitive rash and dermatitis may be caused by many conditions. Hydrochlorothiazide-induced dermatitis is a rare side effect of thiazide diuretics. Early identification of sulfa-sensitivity and photoallergic or phototoxic reaction is essential to accurate diagnosis and treatment of photosensitive dermatitis. Soliciting a targeted history is essential to delineating drug-induced dermatitis from stasis dermatitis. A thorough skin examination can elucidate the focal or...]]>