Fitzgerald Health Education Associates

MAY 2016

Fitzgerald Health Education Associates (FHEA) is committed to the success of nurse practitioners; we publish practical information for practicing NPs and NP students, which includes NP interviews, NP certification Q&A;, avoiding malpractice, and news.

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10 fhea.com Fitzgerald Health Education Associates ™ May 2016 News Briefs Rare But Serious Skin Reactions Associated with Olanzapine The FDA is warning that the antipsychotic medicine olanzapine (Zyprexa, Zyprexa Zydis, Zyprexa Relprevv, Symbyax) can cause a rare but serious skin reaction that can progress to affect other parts of the body. The agency is adding a new warning to the drug labels for all olanzapine-containing products that describes the condition, known as drug reaction with eosinophilia and systemic symptoms (DRESS). The FDA's database identified 23 cases of DRESS asso- ciated with olanzapine that were reported worldwide since 1996 (when the first olanza- pine-containing product was approved). DRESS may start as a rash that spreads to all parts of the body, and includes fever and swollen lymph nodes and a swollen face. DRESS causes a higher-than-normal number of eosinophils and can result in injury to organs including the liver, kidneys, lungs, heart, or pancreas, and can lead to death. DRESS is a potentially fatal drug re- action with a mortality rate of up to 10%. The FDA statement said healthcare profes- sionals should immediately stop treatment with olanzapine if DRESS is suspected. There is no specific treatment for DRESS; early recogni- tion of the syndrome is important for the management of DRESS. Discontinuation of the offending agent as soon as possible and supportive care are required. Treatment with systemic corticosteroids should be considered in cases with extensive organ involvement. For more information, click here . Increased Risk of Leg, Foot Amputations Associated with Canagliflozin The FDA has warned the public about safe- ty results from an ongoing clinical trial that found an increase in leg and foot amputa- tions, mostly affecting the toes, in patients treated with the type 2 diabetes medica- tion canagliflozin (Invokana, Invokamet). The agency is not yet able to determine whether canagliflozin increases the risk of leg and foot amputations and is investigat- ing this new safety issue and will update the public when more is known. Canagliflozin is one of a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. These medications lower blood sugar by causing the kidneys to re- move sugar from the body through the urine. Canagliflozin is available as a single- ingredient product (Invokana) or in combi- nation with metformin (Invokamet). The ongoing trial is the Canagliflozin Car- diovascular Assessment Study (CANVAS). To date, patients in the trial have been fol- lowed for an average of 4.5 years. Data suggest an increased risk of leg and foot amputations; amputations occurred about twice as often in patients treated with canagliflozin compared with patients treat- ed with placebo. A second, similar trial evaluating canagliflozin has not shown the same risks of increased leg and foot ampu- tations to date. The FDA is continuing to monitor the data. For more information, click here . • FDA

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