NMA: Nonprescription Medicines Academy

Quick Takes

April 17th, 2013

  • Self-prescribing of aspirin for primary cardiovascular prevention persists, based on the results of a study conducted in the waiting rooms of two family medicine clinics in Alberta, Canada. Of the 807 patients 50 years of age or older who agreed to complete a questionnaire, 318 (39.8%) reported taking aspirin regularly. The majority of those patients (274, 86%) reported taking aspirin for cardiovascular prevention; 39 of the 274 patients (14.2%) had self-initiated aspirin therapy. The 34 patients who reported self-initiating aspirin for primary prevention represented approximately one fourth (26.4%) of all patients using aspirin for primary prevention.The authors speculated that educating both family physicians and patients about the potential benefits and risks of aspirin therapy might result in fewer patients using aspirin for primary cardiovascular prevention and more patients using aspirin for secondary cardiovascular prevention. (Can Fam Physician. 2013;59:55-61.)
  • According to data presented at the 65th American Academy of Neurology Annual Meeting in San Diego, California, melatonin 3 mg proved to be significantly more efficacious than placebo for migraine prevention and better tolerated than amitriptyline 25 mg. Men and women (18 to 65 years of age) were eligible to participate in the randomized, double-blind, placebo-controlled trial if they experienced two to eight attacks per month of migraine with or without aura. Patients were randomized to receive either placebo, amitriptyline 25 mg, or melatonin 3 mg daily for 3 months; the primary outcome was migraine frequency (number of headache days per month). Among the 179 patients who completed the study, mean reduction in headache frequency was 2.7 in the melatonin group, 2.18 for amitriptyline, and 1.18 for placebo.
  • Nearly all (approximately 90%) of the 110 influenza-associated pediatric deaths reported to the Centers for Disease Control and Prevention (CDC) during the current season occurred in children who had not received a flu vaccination. Although 60% of deaths occurred in children who were at high risk of developing serious flu-related complications, nearly half (40%) occurred in children with no recognized chronic health problems. According to CDC survey data, only about 40% of children had received a 2012-2013 influenza vaccine by mid-November of 2012.
  • Senators Bob Casey (D-PA) and Lisa Murkowski (R-AK) have introduced the Preventing Abuse of Cough Treatments (PACT) Act of 2013, aimed at preventing substance abuse among teenagers. The PACT Act would restrict the nonprescription sale of dextromethorphan to adults 18 years of age or older and ensure that only legitimate entities registered with the FDA or comparable state agencies can purchase raw, unfinished (bulk) dextromethorphan.
  • Pharmacists Michèle Boiron (a family member/owner of Boiron Inc.) and François Roux have released a book titled Homeopathy and Pharmaceutical Care. The book provides an introduction to homeopathic preparations and includes 56 clinical protocols for conditions in which homeopathic medicines might be used. Additional information is available at http://www.homeopharmacare.com/.
  • A new study scheduled for publication in the Journal of Pediatrics found no evidence to support the concern that receiving “too many vaccines too soon” increases the risk of autism. Researchers from the Centers for Disease Control and Prevention (CDC) analyzed data from a case-control study of 256 children with autism spectrum disorder (ASD) and 752 matched control children without ASD conducted in three managed care organizations. Each child’s cumulative exposure to antibody-stimulating proteins and polysaccharides from vaccines during the first 2 years of life was determined by summing the antigen content of each vaccine received; the maximum number of antigens each child received in a single day of vaccination also was calculated. Cumulative antigen exposure by age 2 years and the maximum number of antigens received on a single day were found to be the same for children with and without ASD.
  • Updated and age-adjusted vaccine effectiveness estimates for the 2012–13 influenza vaccine indicate that overall, vaccination reduced the risk for medical visits resulting from influenza A and B by 56%, from influenza A (H3N2) by 47%, and from influenza B by 67%. However, vaccine effectiveness against influenza A (H3N2) was lower (9%) and not statistically significant among adults 65 years of age or older. One possible explanation for these findings is that some older adults did not mount an effective immune response to the influenza A (H3N2) component of this season's vaccine. The complete report can be accessed online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6207a2.htm?s_cid=mm6207a2_w. (MMWR Morb Mortal Wkly Rep. 2013 Feb 22;62:119-23.)
  • In a prospective study of low-dose aspirin users with a high risk of ulcer bleeding, the long-term incidence of recurrent ulcer bleeding was low after H. pylori infection was eradicated. Specifically, the incidence of ulcer bleeding (per 100 patient-years) in an H. pylori-eradicated cohort (0.97; 95% CI, 0.53–1.80) did not differ significantly from that in an average-risk cohort (0.66; 95% CI, 0.38–0.99). The authors concluded that tests for H. pylori infection can be used to assign high-risk aspirin users to groups that require different gastroprotective strategies. (Gastroenterology. 2013;144(3):528-35. Epub 2013 Jan 16.)