Drug and therapeutics bulletin
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About 1 in 100 people has bipolar disorder (manic depression) at some point in their lives.(1) Associated mood swings of depression and mania can be both unpleasant and destructive.(2) It is advised to start medical treatment early, and traditionally this has involved the use of mood stabilisers, antipsychotics and antidepressants.(2) ▾Asenapine (Sycrest - Lundbeck) is a new sublingual antipsychotic drug, licensed for the treatment of moderate to severe manic episodes associated with bipolar I disorder in adults.(3) Here we review the evidence and practical implications associated with the use of this new medication.
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Tapentadol (Palexia - Grünenthal) is a recently introduced strong analgesic with µ-agonistic opioid and additional noradrenaline reuptake inhibition properties. The summary of product characteristics (SPC) states that it is indicated for the relief of moderate to severe acute pain in adults, which can be adequately managed only with opioid analgesics.1 Here we review the place of tapentadol in the treatment of patients with moderate to severe acute pain.
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Current guidelines from the National Institute for Clinical Excellence (NICE) recommend antiplatelet therapy comprising aspirin plus either clopidogrel or prasugrel for patients with acute coronary syndrome (ACS). However, such dual therapy increases the likelihood of bleeding compared to that with aspirin alone. Ticagrelor (Brilique - Astra-Zeneca) is a new oral antiplatelet drug recently licensed in the UK (since publication of the NICE guidelines) for use with aspirin in patients with ACS, including those managed medically or undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Here we review the place of ticagrelor in the management of people with ACS, and whether it offers advantages over standard therapy in terms of greater efficacy or lower likelihood of bleeding complications.
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Estimates suggest that over 3 million people in the UK have chronic obstructive pulmonary disease (COPD).1 Drug management for the condition includes treatments to relieve respiratory symptoms, and prevent and treat acute exacerbations.2,3 ▾Roflumilast (Daxas - Merck Sharp & Dohme) is the first marketed drug in a new class (selective oral phosphodiesterase 4 [PDE4] inhibitors), "aimed at targeting COPD inflammation"4 and licensed as maintenance treatment for severe COPD.5 Here we discuss its place in the management of patients with COPD.