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July 2012 Archives

Valproate Exposure In Utero Decreases Childrens' IQ Scores

Valproate exposure decreases average IQs in children exposed to the drug in utero. Although Antiepileptic Drug (AEDs) use during pregnancy is known to cause congenital malformations, little research has been done on the effect they have on intelligence. A recent study in Neurology looked pregnant women taking four common AEDs and tested their children at 4.5 years of age. Children exposed to Valproate had significantly lower IQ scores (96) than children expose to three other common AEDs, carbamazepine (107), lamotrigine (106) and phenytoin (105).  

Influenza Vaccines and Guillain Barre Syndrome

Influenza vaccines were first noted to be associated with Guillain Barre Syndrome during the 1976 swine flu epidemic, when it was found that the risk of getting paralysis from GBS was increased 4 to 8 times for people who took the vaccine. This increased risk lasted for 6 weeks following the vaccination. GBS is an autoimmune disorder in which the nervous system is damaged with resultant tingling, muscle weakness and paralysis. By stimulating the immune system with vaccines to fight future infections, some people end up with an imune system that attacks them by mistake.  More modern vaccines have undergone attempts to make them safer. A recent study confirms that GBS still occurs following influenza vaccines with 2 people over the age of 50 developing GBS for every one million people vaccinated.

Propecia and Impotence

Propecia (finasteride) causes long lasting and potentially permanent impotence, sexual dysfunction and genital sensation, a newly published study reports. Twenty precent (20%) of men using the drug reported persistent sexual problems that last six or more years.  The people in this study who suffered injury were otherwise healthy young men without any baseline sexual dysfunction or other medical problems. Nine (9) out of 10 men improved or maintained hair with Propecia, but 1 out of 5 men lost the ability to have sex. Merck started selling the drug in 1997 and had sales equal to $134 million last year.

Stroke Therapy Indicated Over Age 80

The  use of intravenous recombinant tissue plaminogen (rt-PA) to treat stroke was initially restricted to treatment in patients under the age of 80 and when started within 3 hours of symptom onset. Treatment with rt-PA can cause lysis of intravascular clots that cause brain ischemia and restore blood flow to affected areas before permanent injury results. The window for treatment was then extended to 4.5 hours after symptom onset, but its use was still restricted to patient less than 80 years of age.

Pradaxa - Uncharted Waters and Emerging Risks

Pradaxa (dabigatran) is an oral factor Xa inhibitor that prevents clotting and has been approved as an effective alternative to the anti-coagulant warfarin (Coumadin). The marketed advantage for Pradaxa is that blood tests are not required to monitor dosage and its effectiveness. The FDA only approved the drug for prevention of thromboembolic stroke in patients with atrial fibrillation. The RE-LY Study used for FDA approval showed that dabigatran was as effective as warfarin. However, within 12 weeks of its approval in October 2010, it was reported that dabigatran was responsible for more serious adverse events than 98.7% of all other medications.

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