Gene Testing Prior to Abacavir Therapy

The News:

The FDA alerted healthcare professionals yesterday that all patients starting or restarting treatment with abacavir or abacavir-containing drugs should be screened for the HLA-B*5701 allele. Patients with this allele are more likely to have serious and sometimes fatal hypersensitivity reactions. If a patient tests positive for this allele, abacavir should not be used. (Source - FDA Safety Alert)

IDIS Related Question:

Locate randomized studies (in adults) about hypersensitivy reactions with abacavir and the use of genetic screening prior to its use.

IDIS Search:

Drug(s): "ABACAVIR 8180817"

Descriptor(s): "SIDE EF IMMUNOLOGIC 90" and "STUDY RANDOMIZE ADULT 135" and "PHARMACOGENETICS 150"

IDIS Results:

IDIS article 590386

Recent Additions to IDIN Answers

The following questions were recently added to IDIN Answers:

What is the Orange Book rating for Nifedical XL 30mg (NDC 00093081901, Teva, Biovail? Is this product bioequivalent to Procardia XL and/or Adalat CC?
(IDIN Answer)

Please see what you can find regarding protocols for acute IV, epidural and SQ pain management. This would entail opiates, local anesthetics and combinations of the two. Ideally we're looking for suggested standard basal and bolus rates as well as maximum basal and bolus rates.
(IDIN Answer)

Do you have any information on gentamicin administered intrathecally?
(IDIN Answer)

How would you taper a patient who mistakenly took 240 mg of prednisone per day?
(IDIN Answer)

Can you please send me daclizumab (Zenapax) dosing information directed towards patients other than renal transplant recipients?
(IDIN Answer)

Can you please check to see if you can find any stability data for iron dextran diluted with normal saline and stored in a plastic syringe?
(IDIN Answer)

I would like any articles or information you can find about continuous infusion of anti-emetics.
(IDIN Answer)

Medication Errors in Neonates

The News:

A medication error with heparin resulted in up to 17 newborns being given an overdose of the drug at a hospital in Texas last week. At least two of these babies have died, but it is unclear if the heparin overdose caused their deaths. Preliminary information indicated that the error originated in the hospital's pharmacy. (Source - theheart.org from WebMD)

IDIS Related Question:

In case reports, what are some other drugs that have been associated with medication errors in neonates?

IDIS Search:

Disease(s): "NEONATE V39."

Descriptor(s): "CASE REPORT PEDIATRIC 1" and "MEDICATION ERROR 158"

IDIS Results:

Acetaminophen (IDIS articles 508779, 467883)

Acyclovir (IDIS article 507354)

Aminophylline (IDIS article 440171)

Epinephrine (IDIS articles 538727, 442155)

Penicillin G benzathine (IDIS articles 454121, 440162)

Cholesterol Medications in Children

The News:

A new guideline issued earlier this month by the American Academy of Pediatrics recommends considering the use of cholesterol-lowering medications in children 8 years or older who have high concentrations of low-density lipoprotein (LDL). (Source - American Academy of Pediatrics Press Release)

IDIS Related Question:

Randomized studies have evaluated the use of statins in children with what disease states?

IDIS Search Strategy:

Drug(s): 240602*

Descriptor(s): "STUDY RANDOMIZE PEDIATRIC 136"

IDIS Results:

Familial hypercholesterolemia (IDIS articles 366237, 488641, 491161, 502435, 518227, 542407, 543590, 580785,
597105)

Severe hypercholesterolemia (IDIS article 502435)

Glomerulonephritis (IDIS article 531359)

IgA nephropathy (IDIS article 501728)

Antiepileptic Drugs and Risk of Suicide

The News:

On July 10, 2008, two FDA Advisory Committees voted not to require that 11 epilepsy drugs carry a black box warning about the risk of suicide ideation and behavior. The drugs being considered for this warning were carbamazepine, divalproex sodium, felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, tiagabine, topiramate, and zonisamide. (Source - MedPage Today)

IDIS Related Question:

What black box warnings, if any, do these 11 drugs currently carry?

IDIS Search Strategy:

Drug(s): "CARBAMAZEPINE 28122007" or "VALPROIC ACID 28122015" or "FELBAMATE 28122022" or "GABAPENTIN 28122020" or "LAMOTRIGINE 28122024" or "LEVETIRACETAM 28122040" or "OXCARBAZEPINE 28122011" or "PREGABALIN 28122016" or "TIAGABINE 28122034" or "TOPIRAMATE 28122035" or "ZONISAMIDE 28122004"

Descriptor(s): "FDA BLACK BOX WARNING 165"

IDIS Results:

Carbamazepine: 1) serious dermatologic reactions and HLA-B*1502 allele 2) aplastic anemia (IDIS article 592789)

Divalproex sodium: 1) hepatotoxicity and 2) teratogenicity (IDIS article 561301)

Felbamate: aplastic anemia (IDIS article 557094)

Lamotrigine: serious rashes requiring hospitalization and discontinuation of treatment (IDIS article 559571)