INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY Int[ J[ Geriatr[ Psychiatry 04\ 0917Ð0922 "1999#J[ B[ GRACE0 \ M[ P[ WALKER1 AND I[ G[ MCKEITH20 Lecturer in Psychiatry \ Department of Old A`e Psychiatry \ Wolfson Research Unit \ Newcastle General Hospital \1 MRC Research Assistant \ MRC Neuropatholo`y Unit \ Newcastle General Hospital \ Newcastle upon Tyne \ UK 2 Professor of Old
Fammed.washington.eduPress Announcements > FDA announces safety changes in labeling for some cholesterol-lowering drugs News & EventsFDA NEWS RELEASEFor Immediate Release: Feb. 28, 2012 Media Inquiries: Erica Jefferson, 301-796-4988, Consumer Inquiries: 888-INFO-FDAFDA announces safety changes in labeling for some cholesterol-lowering drugs Important safety changes to the labeling for some widely used cholesterol-lowering drugs known as statins are being announced today by the U.S. Food and Drug Administration.
These products, when used with diet and exercise, help to lower a person’s “bad” cholesterol (low-density lipoprotein cholesterol). The products include: Lipitor (atorvastatin), Lescol (fluvastatin), Mevacor (lovastatin), Altoprev (lovastatin extended-release), Livalo (pitavastatin), Pravachol (pravastatin), Crestor (rosuvastatin), and Zocor (simvastatin). Combination products include: Advicor (lovastatin/niacin extended- release), Simcor (simvastatin/niacin extended-release), and Vytorin (simvastatin/ezetimibe).
“We want health care professionals and patients to have the most current information on the risks of statins, but also to assure them that these medications continue to provide an important health benefit of lowering cholesterol,” said Mary Parks, M.D., director for the Division of Metabolism and Endocrinology Products in the Office of Drug Evaluation II in FDA’s Center for Drug Evaluation and Research. The changes to the statin labels are: The drug labels have been revised to remove the need for routine periodic monitoring of liver enzymes in patients taking statins. FDA now recommends that liver enzyme tests should be performed before starting statin therapy, and as clinical y indicated thereafter. FDA has concluded that serious liver injury with statins is rare and unpredictable in individual patients, and that routine periodic monitoring of liver enzymes does not appear to be effective in detecting or preventing this rare side effect.
Patients should notify their health care professional immediately if they have the fol owing symptoms of liver problems: unusual fatigue or weakness; loss of appetite; upper bel y pain; dark-colored urine; yel owing of the skin or the whites of the eyes.
Certain cognitive (brain-related) effects have been reported with statin use. Statin labels wil now include information about some patients experiencing memory loss and confusion. These reports general y have not been serious and the patients’ symptoms were reversed by stopping the statin.
However, patients should stil alert their health care professional if these symptoms occur.
Increases in blood sugar levels (hyperglycemia) have been reported with statin use. The FDA is also aware of studies showing that patients being treated with statins may have a smal increased risk of increased blood sugar levels and of being diagnosed with type 2 diabetes mel itus. The labels wil now warn healthcare professionals and patients of this potential risk.
Health care professionals should take note of the new recommendations in the lovastatin label. Some medicines may interact with lovastatin, increasing the risk for muscle injury (myopathy/rhabdomyolysis). For example, certain medicines should never be taken (are contraindicated) with Mevacor (lovastatin) including drugs used to treat HIV (protease inhibitors) and drugs used to treat certain bacterial and fungal infections.
Reporting side effects to the FDA is important. Health care professionals and patients should report any sideeffects associated with statin use to 1.
For more information: www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm293623.htm Press Announcements > FDA announces safety changes in labeling for some cholesterol-lowering drugs 5The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
3. /ForConsumers/ConsumerUpdates/ucm293330.htm 4. /NewsEvents/Newsroom/PressAnnouncements/UCM284955 5. /NewsEvents/Newsroom/PressAnnouncements/ucm294477.htm www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm293623.htm
chapter: Monopoly 1. Each of the following firms possesses market power. Explain its source. a. Merck, the producer of the patented cholesterol-lowering drug Zetia b. WaterWorks, a provider of piped water c. Chiquita, a supplier of bananas and owner of most banana plantations d. The Walt Disney Company, the creators of Mickey Mouse Solution 1. a. Merck has a patent f