FDA update on QT prolongation with Ondansetron

Health Care, Medicine Comments Off

  • A new FDA Drug Safety Communication regarding use of ondansetron states that a single 32-mg intravenous dose of ondansetron may cause QT interval prolongation and should be avoided.
  • QT interval prolongation may, in turn, lead to torsades de pointes, an abnormal and potentially fatal heart arrhythmia.
  • No single intravenous dose should exceed 16 mg.
  • After baseline correction, the maximal mean difference in QTcF from placebo was 20 milliseconds for the 32-mg single intravenous dose and 6 milliseconds for the 8-mg single intravenous dose.
  • Risk factors for QT prolongation associated with use of ondansetron include congenital long QT syndrome, congestive heart failure, bradyarrhythmias, or concomitant use of medications that prolong the QT interval.
  • Before ondansetron is administered, electrolyte abnormalities including hypokalemia or hypomagnesemia should be corrected.

Keeping blood pressure in the safe zone

Health Care, Medicine Comments Off

Keeping your BP below 120/80 is the ideal goal to avoid a host of afflictions, including heart disease, kidney failure and erectile dysfunction.

When lifestyle changes fail to fix the problem, doctors tend to reach for the prescription pad and add medication.

  • Reduce sodium intake. DASH diet keeps sodium to 2,300 milligrams per day (about one teaspoon of salt). Cutting it to 1,500—not easy, but doable—works even better. The DASH diet can lower your systolic pressure (upper number) by 10 points or more.
  • Monitor your pressure at home. This can give you instant feedback on the benefits of diet and exercise and give you and your doctor a more accurate picture of your blood pressure. This is valuable, because some people experience “white coat hypertension,” in which blood pressure spikes higher than normal when measured at the doctor’s office. 
  • Limit your alcohol intake. For men, the suggested limit is one to two alcoholic drinks per day, defined as 1.5 ounces (1 shot glass) of 80-proof spirits, a 5-ounce serving of wine, or a 12-ounce serving of beer. (For women it’s no more than one drink a day.)
  • Take more meds if you need to—but take the right ones.


Probiotics for prevention of the common cold

Health Care, Medicine Comments Off

A meta-analysis of 10 randomized trials compared probiotics (strains of lactobacilli, bifidobacterium, and propionibacterium) with placebo for the prevention of upper respiratory tract infections showed that probiotics decreased the rate of acute respiratory infections but they had no significant effect on the duration of symptoms.

Higher-quality trials that include older adults are needed before it can be determined whether probiotics have a role in the prevention of respiratory tract infections in adults. [Cochrane Database Syst Rev 2011;:CD006895.]

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