Canadian Pharmacy Blog

A baby aspirin taken daily reduces the risk of recurring polyps in patients with advanced adenomas or colorectal cancer, researchers reported at the annual meeting of the American Association for Cancer Research. Their study of 1,121 patients had an unexpected finding: the lower dose (80 mg) had a greater preventive effect, reducing the risk of advanced adenoma by 40%. The 325-mg dose reduced the overall risk of adenoma recurrence by only 4% and the risk of recurrence of advanced adenomas and colorectal cancers by 19%. buy sumatriptan

It is premature to recommend a daily 80-mg aspirin regimen for all adults over 50 years of age, because this group is at an only mildly elevated risk. Study results are going to be analyzed to determine possible reasons for the different effects that resulted from different doses.

According to a new study published in the June 19, 2002 issue of the Journal of the American College of Cardiology, the difference in treatment for heart attacks in men and women might be caused by age rather than by gender.
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The Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada, studied data from 25,697 heart attack patients hospitalized in Ontario between April 1992 and December 1993. They examined the association of age and gender with treatment intensity and five-year survival. The researchers found that rates of angiography (an invasive imaging technique) fell 17.5% for women relative to men with every 10-year increase in age. Although care became progressively less aggressive for women as they aged, their long-term survival rates nevertheless improved compared to those of the men; the relative survival rate in women rose 14.2% for every 10-year increase in age. These results suggest an age bias rather than a gender bias in the treatment of heart attack patients.

The Food and Drug Administration (FDA) has approved rosuvastatin (Drug Crestor®, AstraZeneca) to lower serum cholesterol levels. Lowering cholesterol is a key to reducing the risk of heart disease.

Rosuvastatin is in the class of drugs called HMG-coenzyme A reductase inhibitors, also known as statins. These drugs partially block the synthesis of cholesterol in the liver. This process leads to increased removal of cholesterol from the blood.

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The FDA has granted marketing clearance for drug oxcarbazepine (Trileptal®, Novartis) tablets and oral suspension for use as monotherapy in children four years of age and older with partial seizures. This is the first antiepileptic drug to be approved as a single-agent therapy in children since 1978.

Many children with epilepsy take multiple medications to control seizures, but treating seizure disorders with one medication is preferred; it usually means fewer side effects and better compliance. The approval of Trileptal® as a pediatric monotherapy is considered a step forward in the treatment of childhood epilepsy.

Trileptal® is currently approved in more than 60 countries for use as monotherapy and as adjunctive therapy in children and adults.

The availability of Generic Trileptal® as a single-agent therapy should simplify dosing. A number of older medications for treating partial seizures have resulted in side effects (e.g., mental confusion and memory loss), which might impair concentration.

Since 1993, 4-aminopyridine (4-AP) has been giving hope to patients with spinal injuries, according to a study at the Specialties Hospital in Mexico City. Twenty-seven patients were randomly assigned to receive either oral 4-AP 5 mg/day, increased to a maximum of 30 mg/day, or placebo for 12 weeks. Patients were then switched to the opposite treatment for 12 weeks.

The results from the first 12 weeks were used to test efficacy. Improved motor function, sensation, and independence were observed more often in the patients receiving 4-AP (69%) than in the placebo patients (46%). When each scale was considered separately, motor function was the only marker that improved significantly (92% in the drug group but only 46% in the placebo group).

The researchers also measured whether the drug’s effects persisted after therapy was stopped. At week 24, they found lasting effects in sensation (in 67%) and independence (in 83%) of the 25 patients who finished the study. Five patients experienced a small loss of 4-AP improvements beginning three to four days after they started taking placebo and mainly one week after discontinuing treatment, but no other patients experienced this change.
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One patient who had received 4-AP was partially impaired during the first two weeks of placebo treatment but then improved progressively to reach higher scores on both motor and sensory tests at the end of his placebo treatment— significant differences were seen in his scores at the end of the 4-AP treatment.

Fourteen patients had adverse reactions, which were mostly mild to moderate and transitory.

Although 4-AP is safe, the researchers suggest that patients be monitored for possible peripheral vasospasm and, at the highest dose, for changes in enzyme levels and platelet counts.

A vaccine that protects against human papillomavirus 16 (HPV16), the virus that causes cervical cancer, produces antibodies against HPV16 at the site where cervical cancer develops—a promising indication of the vaccine’s effectiveness. Because antibody levels appear to decrease around the time of ovulation, however, the vaccine might be less effective during that time.

A vaccine is considered promising if it produces an immune response (as determined by antibody levels) at disease-specific sites (e.g., the cervix). Although previous studies showed that an HPV16 vaccine can trigger an immune response and can protect against HPV16 infection, most of these studies involved women who were taking oral contraceptives (which regulate menstruation), and it is unclear what influence changes in hormone levels during the natural menstrual cycle would have on the vaccine’s effectiveness.

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Emtricitabine (Emtriva™, Gilead) is a newly approved 200-mg, one-capsule, once-daily nucleoside reverse transcrip-tase inhibitor (NRTI) for the treatment of human immunodeficiency virus (HIV) infection in adults in combination with other antiretroviral medications. This drug has been evaluated in clinical trials of both newly and previously treated HIV patients.

The Centers for Disease Control and Prevention (CDC) has estimated that 950,000 Americans are infected with HIV, which can progress to acquired immunodeficiency syndrome (AIDS). Approximately 360,000 infected individuals are receiving antiretroviral treatment for HIV infection in the U.S. today.
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Emtricitabine helps to lower the viral load in patients and to increase the number of immune system cells (T cells or CD4 cells). These changes generally lead to improved health and decrease the likelihood of AIDS-related illnesses.

For more background on the treatment of HIV, see the article on antiretroviral therapy in this issue of P&T.