Medication Shortages: March 2019
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Medical Review(S) Clinical Review
CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 200327 MEDICAL REVIEW(S) CLINICAL REVIEW Application Type NDA Application Number(s) 200327 Priority or Standard Standard Submit Date(s) December 29, 2009 Received Date(s) December 30, 2009 PDUFA Goal Date October 30, 2010 Division / Office Division of Anti-Infective and Ophthalmology Products Office of Antimicrobial Products Reviewer Name(s) Ariel Ramirez Porcalla, MD, MPH Neil Rellosa, MD Review Completion October 29, 2010 Date Established Name Ceftaroline fosamil for injection (Proposed) Trade Name Teflaro Therapeutic Class Cephalosporin; ß-lactams Applicant Cerexa, Inc. Forest Laboratories, Inc. Formulation(s) 400 mg/vial and 600 mg/vial Intravenous Dosing Regimen 600 mg every 12 hours by IV infusion Indication(s) Acute Bacterial Skin and Skin Structure Infection (ABSSSI); Community-acquired Bacterial Pneumonia (CABP) Intended Population(s) Adults ≥ 18 years of age Template Version: March 6, 2009 Reference ID: 2857265 Clinical Review Ariel Ramirez Porcalla, MD, MPH Neil Rellosa, MD NDA 200327: Teflaro (ceftaroline fosamil) Table of Contents 1 RECOMMENDATIONS/RISK BENEFIT ASSESSMENT ......................................... 9 1.1 Recommendation on Regulatory Action ........................................................... 10 1.2 Risk Benefit Assessment.................................................................................. 10 1.3 Recommendations for Postmarketing Risk Evaluation and Mitigation Strategies ........................................................................................................................ -
Surgical Decolonization and Prophylaxis
Surgical Decolonization and Prophylaxis SurgicalSurgical Decolonization Decolonization and Prophylaxis and Prophylaxis DECOLONIZATION DECOLONIZATION Nasal Screening Result Recommended Intervention Nasal Screening Result Recommended Intervention MRSA Negative • No decolonization required MSSAMRSA NegativeNegative • No decolonization required MSSA PositiveNegative • Intranasal mupirocin twice daily x 5 days MSSA Positive • Intranasal mupirocin twice daily x 5 days MRSA Positive • Intranasal mupirocin twice daily x 5 days, MRSA Positive AND• Intranasal mupirocin twice daily x 5 days, •ANDChlorhexidine bathing one day prior to surgery ANTIMICROBIAL• ChlorhexidinePROPHYLAXISbathing one day prior to surgery ANTIMICROBIAL PROPHYLAXIS CLINICAL CONSIDERATIONS • Preoperative dose-timing CLINICAL CONSIDERATIONS • PreoperativeWithin 60 minutesdose-timing of surgical incision WithinExceptions: 60 minutes vancomycin of surgicaland fluoroquinolones incision within 120 minutes of surgical incisionExceptions: vancomycin and fluoroquinolones within 120 minutes of surgical • Weightincision-based dosing • WeightCefazolin-based: 2 gm dosingfor patients <120 kg, and 3 gm for patients ≥120 kg Vancomycin:Cefazolin: 2 gm usefor ABW patients <120 kg, and 3 gm for patients ≥120 kg Gentamicin:Vancomycin: use use ABW ABW unless ABW is >120% of their IBW, in which case use AdjBWGentamicin:(see below use ABW for equation)unless ABW is >120% of their IBW, in which case use • DurationAdjBW of(see prophylaxis below for equation) • DurationA single of dose, prophylaxis -
Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals
Journal of Clinical Medicine Review Hormonal Treatment Strategies Tailored to Non-Binary Transgender Individuals Carlotta Cocchetti 1, Jiska Ristori 1, Alessia Romani 1, Mario Maggi 2 and Alessandra Daphne Fisher 1,* 1 Andrology, Women’s Endocrinology and Gender Incongruence Unit, Florence University Hospital, 50139 Florence, Italy; [email protected] (C.C); jiska.ristori@unifi.it (J.R.); [email protected] (A.R.) 2 Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, 50139 Florence, Italy; [email protected]fi.it * Correspondence: fi[email protected] Received: 16 April 2020; Accepted: 18 May 2020; Published: 26 May 2020 Abstract: Introduction: To date no standardized hormonal treatment protocols for non-binary transgender individuals have been described in the literature and there is a lack of data regarding their efficacy and safety. Objectives: To suggest possible treatment strategies for non-binary transgender individuals with non-standardized requests and to emphasize the importance of a personalized clinical approach. Methods: A narrative review of pertinent literature on gender-affirming hormonal treatment in transgender persons was performed using PubMed. Results: New hormonal treatment regimens outside those reported in current guidelines should be considered for non-binary transgender individuals, in order to improve psychological well-being and quality of life. In the present review we suggested the use of hormonal and non-hormonal compounds, which—based on their mechanism of action—could be used in these cases depending on clients’ requests. Conclusion: Requests for an individualized hormonal treatment in non-binary transgender individuals represent a future challenge for professionals managing transgender health care. For each case, clinicians should balance the benefits and risks of a personalized non-standardized treatment, actively involving the person in decisions regarding hormonal treatment. -
Prediction of Premature Termination Codon Suppressing Compounds for Treatment of Duchenne Muscular Dystrophy Using Machine Learning
Prediction of Premature Termination Codon Suppressing Compounds for Treatment of Duchenne Muscular Dystrophy using Machine Learning Kate Wang et al. Supplemental Table S1. Drugs selected by Pharmacophore-based, ML-based and DL- based search in the FDA-approved drugs database Pharmacophore WEKA TF 1-Palmitoyl-2-oleoyl-sn-glycero-3- 5-O-phosphono-alpha-D- (phospho-rac-(1-glycerol)) ribofuranosyl diphosphate Acarbose Amikacin Acetylcarnitine Acetarsol Arbutamine Acetylcholine Adenosine Aldehydo-N-Acetyl-D- Benserazide Acyclovir Glucosamine Bisoprolol Adefovir dipivoxil Alendronic acid Brivudine Alfentanil Alginic acid Cefamandole Alitretinoin alpha-Arbutin Cefdinir Azithromycin Amikacin Cefixime Balsalazide Amiloride Cefonicid Bethanechol Arbutin Ceforanide Bicalutamide Ascorbic acid calcium salt Cefotetan Calcium glubionate Auranofin Ceftibuten Cangrelor Azacitidine Ceftolozane Capecitabine Benserazide Cerivastatin Carbamoylcholine Besifloxacin Chlortetracycline Carisoprodol beta-L-fructofuranose Cilastatin Chlorobutanol Bictegravir Citicoline Cidofovir Bismuth subgallate Cladribine Clodronic acid Bleomycin Clarithromycin Colistimethate Bortezomib Clindamycin Cyclandelate Bromotheophylline Clofarabine Dexpanthenol Calcium threonate Cromoglicic acid Edoxudine Capecitabine Demeclocycline Elbasvir Capreomycin Diaminopropanol tetraacetic acid Erdosteine Carbidopa Diazolidinylurea Ethchlorvynol Carbocisteine Dibekacin Ethinamate Carboplatin Dinoprostone Famotidine Cefotetan Dipyridamole Fidaxomicin Chlormerodrin Doripenem Flavin adenine dinucleotide -
Antimicrobial Stewardship Guidance
Antimicrobial Stewardship Guidance Federal Bureau of Prisons Clinical Practice Guidelines March 2013 Clinical guidelines are made available to the public for informational purposes only. The Federal Bureau of Prisons (BOP) does not warrant these guidelines for any other purpose, and assumes no responsibility for any injury or damage resulting from the reliance thereof. Proper medical practice necessitates that all cases are evaluated on an individual basis and that treatment decisions are patient-specific. Consult the BOP Clinical Practice Guidelines Web page to determine the date of the most recent update to this document: http://www.bop.gov/news/medresources.jsp Federal Bureau of Prisons Antimicrobial Stewardship Guidance Clinical Practice Guidelines March 2013 Table of Contents 1. Purpose ............................................................................................................................................. 3 2. Introduction ...................................................................................................................................... 3 3. Antimicrobial Stewardship in the BOP............................................................................................ 4 4. General Guidance for Diagnosis and Identifying Infection ............................................................. 5 Diagnosis of Specific Infections ........................................................................................................ 6 Upper Respiratory Infections (not otherwise specified) .............................................................................. -
AMEG Categorisation of Antibiotics
12 December 2019 EMA/CVMP/CHMP/682198/2017 Committee for Medicinal Products for Veterinary use (CVMP) Committee for Medicinal Products for Human Use (CHMP) Categorisation of antibiotics in the European Union Answer to the request from the European Commission for updating the scientific advice on the impact on public health and animal health of the use of antibiotics in animals Agreed by the Antimicrobial Advice ad hoc Expert Group (AMEG) 29 October 2018 Adopted by the CVMP for release for consultation 24 January 2019 Adopted by the CHMP for release for consultation 31 January 2019 Start of public consultation 5 February 2019 End of consultation (deadline for comments) 30 April 2019 Agreed by the Antimicrobial Advice ad hoc Expert Group (AMEG) 19 November 2019 Adopted by the CVMP 5 December 2019 Adopted by the CHMP 12 December 2019 Official address Domenico Scarlattilaan 6 ● 1083 HS Amsterdam ● The Netherlands Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 An agency of the European Union © European Medicines Agency, 2020. Reproduction is authorised provided the source is acknowledged. Categorisation of antibiotics in the European Union Table of Contents 1. Summary assessment and recommendations .......................................... 3 2. Introduction ............................................................................................ 7 2.1. Background ........................................................................................................ -
New Drugs Are Not Enough‑Drug Repositioning in Oncology: an Update
INTERNATIONAL JOURNAL OF ONCOLOGY 56: 651-684, 2020 New drugs are not enough‑drug repositioning in oncology: An update ROMINA GABRIELA ARMANDO, DIEGO LUIS MENGUAL GÓMEZ and DANIEL EDUARDO GOMEZ Laboratory of Molecular Oncology, Science and Technology Department, National University of Quilmes, Bernal B1876, Argentina Received August 15, 2019; Accepted December 16, 2019 DOI: 10.3892/ijo.2020.4966 Abstract. Drug repositioning refers to the concept of discov- 17. Lithium ering novel clinical benefits of drugs that are already known 18. Metformin for use treating other diseases. The advantages of this are that 19. Niclosamide several important drug characteristics are already established 20. Nitroxoline (including efficacy, pharmacokinetics, pharmacodynamics and 21. Nonsteroidal anti‑inflammatory drugs toxicity), making the process of research for a putative drug 22. Phosphodiesterase-5 inhibitors quicker and less costly. Drug repositioning in oncology has 23. Pimozide received extensive focus. The present review summarizes the 24. Propranolol most prominent examples of drug repositioning for the treat- 25. Riluzole ment of cancer, taking into consideration their primary use, 26. Statins proposed anticancer mechanisms and current development 27. Thalidomide status. 28. Valproic acid 29. Verapamil 30. Zidovudine Contents 31. Concluding remarks 1. Introduction 2. Artesunate 1. Introduction 3. Auranofin 4. Benzimidazole derivatives In previous decades, a considerable amount of work has been 5. Chloroquine conducted in search of novel oncological therapies; however, 6. Chlorpromazine cancer remains one of the leading causes of death globally. 7. Clomipramine The creation of novel drugs requires large volumes of capital, 8. Desmopressin alongside extensive experimentation and testing, comprising 9. Digoxin the pioneer identification of identifiable targets and corrobora- 10. -
Antibiotic Review
8/28/19 Disclosure 2 E. Monee’ Carter-Griffin DNP, MA, RN, ACNP-BC Antibiotic has no financial relationships with commercial Review interests to disclose. Any unlaBeled and/or E. Monee’ Carter-Griffin, DNP, MA, RN, ACNP-BC unapproved uses of drugs or products will Be Associate Chair for Advanced Practice Nursing disclosed. University of Texas at Arlington, College of Nursing & Health Innovation Dallas Pulmonary & Critical Care, PA • Identify the general characteristics of • SusceptiBility à determine which antibiotics. antibiotics a bacteria is sensitive to • Discuss the mechanism of action, • à pharmacokinetics, and spectrum of activity MIC lowest concentration of drug that inhiBits growth of the Bacteria for the most common antiBiotic drug classes. Antibiotic Objectives • Identify commonly prescriBed antiBiotics • Trough à lowest concentration of within the drug classes including dosage Lingo drug in bloodstream range and indication for prescribing. – Collect prior to administration of • Identify special considerations for specific drug antibiotics and/or drug classes. • Peak à highest concentration of • Practice appropriate prescriBing for common drug in bloodstream bacterial infections. • Review Basic antiBiotic stewardship 3 4 principles. • Penicillins • Bactericidal or bacteriostatic • Cephalosporins • Narrow or Broad spectrum • Carbapenems General • Can elicit allergic responses Antibiotic • MonoBactam Characteristics • Affect normal Body flora Drug Classes • Macrolides • Fluoroquinolones • Sulfonamides • Tetracyclines 5 6 1 8/28/19 • Penicillins – Natural penicillins 8 – Aminopenicillins Penicillins Penicillins – Anti-staphylococcal penicillins • Mechanism of action àbactericidal à – Anti-pseudomonal penicillins interrupts cell wall synthesis 7 • Pharmacokinetics • Spectrum of Activity – Gram positive organisms Natural – Penicillin G à mostly given IM, But Natural • Streptococcus species (e.g. S. Penicillins one variation can Be given IV Penicillins pyogenes) • Poorly aBsorBed via PO • Some enterococcus species (e.g. -
Computational Antibiotics Book
Andrew V DeLong, Jared C Harris, Brittany S Larcart, Chandler B Massey, Chelsie D Northcutt, Somuayiro N Nwokike, Oscar A Otieno, Harsh M Patel, Mehulkumar P Patel, Pratik Pravin Patel, Eugene I Rowell, Brandon M Rush, Marc-Edwin G Saint-Louis, Amy M Vardeman, Felicia N Woods, Giso Abadi, Thomas J. Manning Computational Antibiotics Valdosta State University is located in South Georgia. Computational Antibiotics Index • Computational Details and Website Access (p. 8) • Acknowledgements (p. 9) • Dedications (p. 11) • Antibiotic Historical Introduction (p. 13) Introduction to Antibiotic groups • Penicillin’s (p. 21) • Carbapenems (p. 22) • Oxazolidines (p. 23) • Rifamycin (p. 24) • Lincosamides (p. 25) • Quinolones (p. 26) • Polypeptides antibiotics (p. 27) • Glycopeptide Antibiotics (p. 28) • Sulfonamides (p. 29) • Lipoglycopeptides (p. 30) • First Generation Cephalosporins (p. 31) • Cephalosporin Third Generation (p. 32) • Fourth-Generation Cephalosporins (p. 33) • Fifth Generation Cephalosporin’s (p. 34) • Tetracycline antibiotics (p. 35) Computational Antibiotics Antibiotics Covered (in alphabetical order) Amikacin (p. 36) Cefempidone (p. 98) Ceftizoxime (p. 159) Amoxicillin (p. 38) Cefepime (p. 100) Ceftobiprole (p. 161) Ampicillin (p. 40) Cefetamet (p. 102) Ceftoxide (p. 163) Arsphenamine (p. 42) Cefetrizole (p. 104) Ceftriaxone (p. 165) Azithromycin (p.44) Cefivitril (p. 106) Cefuracetime (p. 167) Aziocillin (p. 46) Cefixime (p. 108) Cefuroxime (p. 169) Aztreonam (p.48) Cefmatilen ( p. 110) Cefuzonam (p. 171) Bacampicillin (p. 50) Cefmetazole (p. 112) Cefalexin (p. 173) Bacitracin (p. 52) Cefodizime (p. 114) Chloramphenicol (p.175) Balofloxacin (p. 54) Cefonicid (p. 116) Cilastatin (p. 177) Carbenicillin (p. 56) Cefoperazone (p. 118) Ciprofloxacin (p. 179) Cefacetrile (p. 58) Cefoselis (p. 120) Clarithromycin (p. 181) Cefaclor (p. -
Surgical Prophylaxis Antibiotic Recommendations Updated 2017
Surgical Prophylaxis Antibiotic Recommendations Updated 2017 1. Prophylactic antibiotic is to be initiated within 1 hour prior to incision Exception: Due to the longer infusion time required, initiate vancomycin and ciprofloxacin within 2 hours prior to incision 2. Anesthesia to give preoperative antibiotic dose and document time on anesthesia record. Exception: Antibiotics in Endoscopy, Labor and Delivery and Birth Care Center 3. Chose alternative antibiotic if patient is allergic to recommended first line antibiotic. Avoid giving cefazolin or cefotetan if the patient has allergies to cephalosporins or a life- threatening allergy to penicillin (angioedema, bronchoconstriction, cardiac arrhythmias, hypotension, or respiratory distress) 4. Pediatric Patients: Maximum dose is dose listed for wt <80 kg. For pediatric patients >80 kg, follow adult dosing. 5. For patients colonized with MRSA: Give vancomycin as the pre-op antibiotics for cardiac, vascular, orthopedic, neurological, and head and neck surgeries. For all other surgeries, give vancomycin in addition to the antibiotics listed below. To determine if a patient is colonized with MRSA, please see flow sheet below. 6. Per Clinical Practice Restricted/High Risk Medications with Special Requirements Policy: Pre-operative antibiotics for prophylaxis in adult patients will be automatically substituted to the antibiotics listed on Adult Surgical Pre-Operative Antibiotic Prophylaxis order set #347. For surgeries/procedures not addressed on the order set, anesthesia is to discuss antibiotic selection with the surgeon. 7. Antibiotics listed below are listed in order of preference. The first line antibiotic has been designated with an asterisks(*). Dose Surgical Procedure Drug Pediatrics (<80 kg), Wt <80 kg Wt 80-119 kg Wt ≥ 120 kg If applicable Coronary Artery Bypass Graft Cardiac Surgery cefazolin IV* 1 gm 2 gm 3 gm Vascular Surgery All CABG, Valves and other CV procedures Pacemakers, AICD’s, pocket vancomycin IV (MRSA or 1 gm 1.5 gm 2 gm relocation and lead revisions, allergy) generator replacements. -
Cephalosporins Can Be Prescribed Safely for Penicillin-Allergic Patients ▲
JFP_0206_AE_Pichichero.Final 1/23/06 1:26 PM Page 106 APPLIED EVIDENCE New research findings that are changing clinical practice Michael E. Pichichero, MD University of Rochester Cephalosporins can be Medical Center, Rochester, NY prescribed safely for penicillin-allergic patients Practice recommendations an allergic reaction to cephalosporins, ■ The widely quoted cross-allergy risk compared with the incidence of a primary of 10% between penicillin and (and unrelated) cephalosporin allergy. cephalosporins is a myth (A). Most people produce IgG and IgM antibodies in response to exposure to ■ Cephalothin, cephalexin, cefadroxil, penicillin1 that may cross-react with and cefazolin confer an increased risk cephalosporin antigens.2 The presence of of allergic reaction among patients these antibodies does not predict allergic, with penicillin allergy (B). IgE cross-sensitivity to a cephalosporin. ■ Cefprozil, cefuroxime, cefpodoxime, Even penicillin skin testing is generally not ceftazidime, and ceftriaxone do not predictive of cephalosporin allergy.3 increase risk of an allergic reaction (B). Reliably predicting cross-reactivity ndoubtedly you have patients who A comprehensive review of the evidence say they are allergic to penicillin shows that the attributable risk of a cross- U but have difficulty recalling details reactive allergic reaction varies and is of the reactions they experienced. To be strongest when the chemical side chain of safe, we often label these patients as peni- the specific cephalosporin is similar to that cillin-allergic without further questioning of penicillin or amoxicillin. and withhold not only penicillins but Administration of cephalothin, cepha- cephalosporins due to concerns about lexin, cefadroxil, and cefazolin in penicillin- potential cross-reactivity and resultant IgE- allergic patients is associated with a mediated, type I reactions. -
WHO Model List (Revised April 2003) Explanatory Notes
13th edition (April 2003) Essential Medicines WHO Model List (revised April 2003) Explanatory Notes The core list presents a list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and cost-effective treatment. The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities, and/or specialist medical care, and/or specialist training are needed. In case of doubt medicines may also be listed as complementary on the basis of consistent higher costs or less attractive cost-effectiveness in a variety of settings. When the strength of a drug is specified in terms of a selected salt or ester, this is mentioned in brackets; when it refers to the active moiety, the name of the salt or ester in brackets is preceded by the word "as". The square box symbol (? ) is primarily intended to indicate similar clinical performance within a pharmacological class. The listed medicine should be the example of the class for which there is the best evidence for effectiveness and safety. In some cases, this may be the first medicine that is licensed for marketing; in other instances, subsequently licensed compounds may be safer or more effective. Where there is no difference in terms of efficacy and safety data, the listed medicine should be the one that is generally available at the lowest price, based on international drug price information sources.