News, Updates, and Links
Recommendations regarding Digitek:
(Reviewed 04/30/2008)
Phone Message regarding Digitek
(509) 744 1521 ext 301
Actavis Totowa LLC, a United States manufacturing division of the international generic pharmaceutical company Actavis Group, is initiating a Class 1 nationwide recall of Digitek (digoxin tablets, USP, all strengths) for oral use. The products are distributed by Mylan Pharmaceuticals, Inc. under a "Bertek" label and by UDL Laboratories, Inc. under a "UDL" label.
The voluntary all-lot recall is due to the possibility that tablets with double the appropriate thickness may have been commercially released. These tablets may contain twice the approved level of active ingredient than is appropriate
If your digoxin has the brand name Digitek:
Vytorin after the Enhance Study:
(Reviewed 04/29/2008)
There is not a safety concern raised by this study.
The study failed to show significant differences between Vytorin 10/80 and Zocor 80mg.
The study probably had such an unusual group of patients that the results are not clinically useful.
Both the study group and placebo group failed to get their LDL below 140. (Vytorin did lower the LDL more than Zocor 193 vs 141)
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If you are having no problems, we would not suggest changing medications.
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We are still following guidelines that suggest for high risk patients LDL should be less than 100 and for very high risk patients the LDL should be less than 70.
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Vytorin has proved remarkably effective in lowering LDL.
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We are still awaiting event reduction trials with this (and all) combination therapies.
Phone Update on Spokane Cardiology Recommendations regarding Vytorin\Zocor
(509) 744-1524 ext 302
Duration of Plavix Therapy after a Stent:
(Reviewed 4/30/2008)
ACC/AHA/SCAI PCI Practice Guidelines recommend that patients receive
Aspirin indefinitely
Plavix (Clopidogrel)
- a minimum of 3 months (for Cypher patients)
- a minimum of 6 months (for TAXUS patients)
- therapy for both extended to 12 months in patients at a low risk of bleeding.
Recommendations regarding NSAIDS (Motrin etc)
(Reviewed 5/1/2008)
NSAID medicines may increase the chance of a heart attack or stroke that can lead to death. This chance increases:
NSAID medicines should never be used right before or after a heart surgery called a “coronary artery bypass graft (CABG)."
NSAID medicines can cause ulcers and bleeding in the stomach and intestines at any time during treatment.
Antibiotic Propholaxis (Antibiotics to Prevent Infective Endocarditis):
(Reviewed 05/02/2008)
The American Heart Association recently updated its guidelines regarding which patients should take a precautionary antibiotic to prevent infective endocarditis (IE) before a trip to the dentist.
The guidelines, published in Circulation: Journal of the American Heart Association, are based on a growing body of scientific evidence that shows that, for most people, the risks of taking prophylaxis antibiotics for certain procedures outweigh the benefits. These guidelines represent a major change in philosophy.
The new guidelines show taking preventive antibiotics is not necessary for most people and, in fact, might create more harm than good. Unnecessary use of antibiotics could cause allergic reactions and dangerous antibiotic resistance.
Only the people at greatest risk of bad outcomes from infective endocarditis — an infection of the heart's inner lining or the heart valves — should receive short-term preventive antibiotics before common, routine dental and medical procedures.
Patients at the greatest danger of bad outcomes from IE and for whom preventive antibiotics are worth the risks include those with:
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artificial heart valves
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a history of having had IE
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certain specific, serious congenital (present from birth) heart conditions, including:
- unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
- a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter interventions, during the first six months after the procedure
-any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or prosthetic device
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a cardiac transplant which develops a problem in a heart valve.