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Journal Cover The Medical Letter
  [SJR: 0.142]   [H-I: 16]   [5 followers]  Follow
   Full-text available via subscription Subscription journal
   ISSN (Print) 0025-732X - ISSN (Online) 1523-2859
   Published by The Medical Letter, Inc Homepage  [1 journal]
  • Reslizumab (Cinqair) for Severe Eosinophilic Asthma
    • Authors: admin
      Abstract: Date:  June 20, 2016 Issue #:  1497 Summary:  The FDA has approved reslizumab (Cinqair – Teva), a humanized interleukin-5 (IL-5) antagonist monoclonal antibody, for add-on maintenance treatment of severe asthma in adults who have an eosinophilic phenotype. It is the second IL-5 antagonist to be approved in the US; mepolizumab (Nucala) was approved for the same indication in 2015.
      PubDate: Wed, 01 Jun 2016 11:27:57 +000
  • Two New Amphetamines for ADHD
    • Authors: admin
      Abstract: Date:  June 20, 2016 Issue #:  1497 Summary:  Two new extended-release amphetamine products have been approved by the FDA for once-daily treatment of attention-deficit/hyperactivity disorder (ADHD) in patients ≥6 years old: Adzenys XR-ODT (Neos Therapeutics), an orally distintegrating tablet, and Dyanavel XR (Tris Pharma), an oral suspension.
      PubDate: Wed, 01 Jun 2016 11:27:25 +000
  • A New Abuse-Deterrent Opioid - Xtampza ER
    • Authors: admin
      Abstract: Date:  June 20, 2016 Issue #:  1497 Summary:  The FDA has approved Xtampza ER (Collegium), a new extended-release, abuse-deterrent capsule formulation of oxycodone, for management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.
      PubDate: Wed, 01 Jun 2016 11:26:52 +000
  • Addendum: Doxycycline for Young Children'
    • Authors: admin
      Abstract: Date:  June 20, 2016 Issue #:  1497 Summary:  A reader commenting on our Treatment of Lyme Disease article (Med Lett Drugs Ther 2016; 58:57) objected to a footnote in the table advising against use of doxycycline in children <8 years old. This warning has been included in the labeling of all tetracyclines since 1970 when it was recognized, after decades of use, that these drugs caused permanent staining and enamel hypoplasia of developing teeth. The CDC recently stated that short courses of doxycycline, which was first marketed in the US in 1967 and has less affnity for calcium than other tetracyclines, have not been shown to cause tooth staining.1 That statement was prompted by the discovery that children <10 years old have a disproportionately high fatality rate from rickettsial diseases, particularly Rocky Mountain spotted fever, for which doxycycline is the drug of choice and chloramphenicol is the only proven alternative.

      The main evidence supporting the CDC's statement was a retrospective cohort study consisting of a record review and dental examination of 271 children living on a Native American reservation. No staining was detected in any of the 58 children who had been treated with doxycycline before the age of 8 years or in any of the 213 children who had not been exposed to the drug. Enamel hypoplasia was present in 4% of children in both cohorts.2

      Lyme disease, unlike Rocky Mountain spotted fever, is seldom fatal and can be treated with antibiotics other than doxycycline. A single dose of doxycycline is recommended for prophylaxis after a tick bite. Given the CDC's statement about its safety, it would seem reasonable to use doxycycline for prophylaxis in all age groups. When longer treatment courses (10, 14, or 28 days) are recommended for the various clinical manifestations of Lyme disease in children <8 years old, alternative antibiotics generally could be used instead.

      HM Biggs et al. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group Rickettsioses, Ehrlichioses, and Anaplasmosis – United States. MMWR Recomm Rep 2016; 65:1.
      SR Todd et al. No visible dental staining in children treated with doxycycline for suspected Rocky Mountain spotted fever. J Pediatr 2015; 166:1246.

      Download complete U.S. English article

      PubDate: Wed, 01 Jun 2016 11:26:13 +000
  • Spritam - A New Formulation of Levetiracetam for Epilepsy
    • Authors: admin
      Abstract: Date:  June 20, 2016 Issue #:  1497 Summary:  The FDA has approved a rapidly disintegrating tablet formulation of the antiepileptic drug levetiracetam (Spritam – Aprecia) for adjunctive treatment of partialonset, myoclonic, and primary generalized tonicclonic seizures. Oral and intravenous formulations of levetiracetam (Keppra, and generics) have been available for years. Although approved by the FDA only as adjunctive therapy, levetiracetam is commonly used as monotherapy for partial-onset and generalized seizures and may also be effective in treating absence seizures and seizures of Lennox-Gastaut syndrome.
      PubDate: Wed, 18 May 2016 12:13:37 +000
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