What’s New in Medicine

• Do not prescribe citalopram at doses that exceed 40 mg per day because of dose–dependent QT interval prolongation.
• For most patients with LVEF of 35 percent or less and coronary artery disease (CAD) amenable to CABG surgery, initiate course of optimal medical therapy alone rather than medical therapy plus CABG surgery.
• Four types of commonly–used medication (warfarin, insulin, oral antiplatelet agents, and oral hypoglycemics) accounted for 67.0 percent of the adverse drug events in elderly.
• In 2012, the US FDA revised its labeling information on statins to only recommend liver function testing prior to initiation of statin therapy and to only repeat such testing for clinical indications. Routine monitoring of liver function tests in patients receiving statin therapy is not necessary.
• Proton pump inhibitors may be associated with an increased risk of C. difficile–associated diarrhea.
• Rifapentine is a rifamycin derivative with a long half–life and greater potency against M. tuberculosis than rifampin. A 3–month regimen of weekly isoniazid and rifapentine given as directly–observed therapy has been shown to be non inferior to a 9–month self–administered regimen of daily isoniazid in a randomized, open label international trial in predominantly HIV–negative individuals at high risk for progression from latent tuberculosis infection to active infection
• Exercise may modestly improve obstructive sleep apnea (OSA) even in the absence of significant weight loss.
• Intravenous paracetamol is available in a concentration of 10 mg/mL. Ten–fold iatrogenic overdoses have been described in hospitalized young children receiving it. The typical error occurs when the dose in mg is mistakenly given as the volume in mL.
• A high sodium diet is associated with both a blunting of the proteinuria reduction induced by the ACE inhibitor ramipril and a higher incidence of end–stage renal disease in proteinuric patients with chronic kidney disease enrolled into the REIN and REIN–2 trials
• A prolonged corrected QT interval on a resting ECG has limited sensitivity for the detection of long QT syndrome. A multicenter study found that a prolonged QTc during exercise recovery provided greater sensitivity.