Vilazodone hydrochloride, a combined SSRI and 5-HT1A receptor agonist for major depressive disorder.

Objective: Vilazodone (VIIBRYD, Trovis Pharmaceuticals; New Haven, Connecticut, also known as 659746, EMD68843, SB-659746-A) is a newly introduced antidepressant that has taken approximately a decade from its discovery to approval by the Food and Drug Administration. This paper will review the chemistry, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, drug-drug interaction potential, dosing, and administration of this agent.

Data Sources: Medline/PubMed/IPA/EMBASE databases were searched using the terms "vilazodone," "659746," "EMD68843," and "SB-659746-A.

Comment on the potential utility of the new atypical antipsychotic lurasidone in the geriatric population.

Lurasidone is the tenth atypical antipsychotic to be marketed in the United States. Like other atypical agents, lurasidone binds to a variety of central nervous system receptors, including dopamine (D2), norepinephrine (alpha 2A and 2C), and serotonin (1A, 2A, and 7) receptors. At these receptors, the drug acts as an antagonist except at serotonin 1A receptors, where it is a partial agonist.

Dabigatran etexilate: a possible replacement for heparinoids and vitamin K antagonists?

Dabigatran etexilate is the first oral anticoagulant to be approved in the United States in decades. It works directly by inhibiting clot-bound and free factor IIa (ie, thrombin) and indirectly by inhibiting platelet aggregation induced by thrombin. It is approved in the United States for stroke prophylaxis in nonvalvular atrial fibrillation.

Oral hydromorphone extended-release.

Objective: To review the chemistry, pharmacodynamics, pharmacokinetics, efficacy, tolerability, dosing, and role of the Osmotic-controlled Release Oral delivery System (OROS) hydromorphone extended-release (ER) tablets.

Data Source: A MEDLINE/PUBMED search (1986-August 2010) was conducted to identify studies in the English language, with additional references being obtained from their bibliographies.

Study Selection: All studies of hydromorphone ER were reviewed.

Tetrabenazine, a monoamine-depleting drug used in the treatment of hyperkinetic movement disorders.

Background: Few drugs are available for the management of hyperkinetic movement disorders such as the dystonias, choreas, dyskinesias, and tics. Those that are available (primarily neuroleptics) are associated with a wide range of potentially serious adverse effects, including induction of tardive movement disorders. Tetrabenazine (TBZ) is a monoamine-depleting agent initially studied in the 1950s and currently approved by the US Food and Drug Administration for the treatment of chorea in Huntington's disease.

Is tapentadol an advance on tramadol?

Objective: To review the pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, dosing, and administration of tapentadol, a combination mu-opioid-receptor agonist and monoamine-reuptake inhibitor, and compare it with tramadol, the first drug in this class.

Data Sources: MEDLINE/PUBMED and EMBASE searches (1986 through March 2009) were conducted to identify pertinent English-language papers. In addition, meeting abstracts from multiple pain specialty organizations were searched (2000 through 2008).

Methylnaltrexone methobromide: the first peripherally active, centrally inactive opioid receptor-antagonist.

Objective: To review the chemistry, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, indications, and dosing and administration of methylnaltrexone methobromide, the first approved peripherally selective opioid receptor-antagonist.

Data Source: MEDLINE/PUBMED and EMBASE searches (January 1966-February 2009) were conducted to identify pertinent English-language studies.

Study Selection And Data Extraction: All studies evaluating any aspect of methylnaltrexone methobromide.

Cranberry and urinary tract infections.

Urinary tract infection (UTI) refers to the presence of clinical signs and symptoms arising from the genitourinary tract plus the presence of one or more micro-organisms in the urine exceeding a threshold value for significance (ranges from 102 to 103 colony-forming units/mL). Infections are localized to the bladder (cystitis), renal parenchyma (pyelonephritis) or prostate (acute or chronic bacterial prostatitis). Single UTI episodes are very common, especially in adult women where there is a 50-fold predominance compared with adult men.

Drug treatment of paraphilic and nonparaphilic sexual disorders.

Background: Paraphilias are characterized by recurrent, intense, sexually arousing fantasies, urges, or behaviors, over a period of > or =6 months, generally involving nonhuman objects, suffering or humiliation of oneself or one's partner, or children or other nonconsenting persons. These fantasies, urges, and behaviors produce clinically significant distress or impairments in social, occupational, and other important areas of functioning.

Objective: The goal of this article was to provide an in-depth review of the clinical pharmacology of the main antiandrogens (cyproterone acetate, medroxyprogesterone acetate [MPA], and the luteinizing hormone-releasing hormone [LHRH] agonists) used in the treatment of the paraphilias, as well as a discussion of the relevant clinical case reports, case series, and controlled trials.

Inappropriate sexual behaviors in cognitively impaired older individuals.

Background: Agitated and aggressive behaviors are common in older patients with dementia (33% of the community-dwelling and 80% of the institutionalized populations). Although inappropriate verbal and physical sexual behaviors are among the least common of these actions, they can be profoundly disruptive to caregivers (spouse, institutional staff, or both) and other individuals in the immediate surroundings. Substantial mental and physical harm can occur secondary to these behaviors.

Contemporary management of uncomplicated urinary tract infections.

Uncomplicated urinary tract infections (uUTIs) are common in adult women across the entire age spectrum, with mean annual incidences of approximately 15% and 10% in those aged 15-39 and 40-79 years, respectively. By definition, UTIs in males or pregnant females and those associated with risk factors known to increase the risk of infection or treatment failure (e.g.

Drug forecast - the peptide deformylase inhibitors as antibacterial agents.

The relatively rapid development of microbial resistance after the entry of every new antimicrobial into the marketplace necessitates a constant supply of new agents to maintain effective pharmacotherapy. Despite extensive efforts to identify novel lead compounds from molecular targets, only the peptide deformylase inhibitors (PDIs) have shown any real promise, with some advancing to phase I human trials. Bacterial peptide deformylase, which catalyzes the removal of the N-formyl group from N-terminal methionine following translation, is essential for bacterial protein synthesis, growth, and survival.

Newer antiepileptic drugs in the management of agitation/aggression in patients with dementia or developmental disability.

Objective: To assess the potential role of newer antiepileptic drugs (AEDs) in the management of agitation/aggression in patients with dementia or developmental disability.

Data Source: A MEDLINE/PUBMED search (1986-May 2007) was conducted to identify pertinent English language studies of six newer AEDs, as well as carbamazepine and valproate, in the management of agitation/aggression.

Study Selection And Data Extraction: All studies evaluating any aspect of management of agitation/aggression, emphasizing those associated with dementia or developmental disability.

Topical clindamycin in the management of acne vulgaris.

A small cadre of antimicrobials are commonly used and regarded as effective and safe, as systemic and topical treatments of acne vulgaris. These include oral tetracycline, doxycycline, minocycline and topical clindamycin and erythromycin. Topical antimicrobials work via both antimicrobial and non-antimicrobial mechanisms: the former due to suppression of the growth of propionibacterial species (especially Propionibacterium acnes and P.

Use of oral oxymorphone in the elderly.

Objective: To review the pharmacodynamics, pharmacokinetics, efficacy, tolerability, dosing, and role of oral oxymorphone immediate-release (IR) and extended-release (ER).

Data Source: A MEDLINE/PUBMED search (1970 to September 2006) of English language studies. Additional references were obtained from their bibliographies.

Rasagiline (TVP-1012): a new selective monoamine oxidase inhibitor for Parkinson's disease.

Objective: This article reviews the chemistry, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, drug-interaction potential, indications, dosing, and potential role of rasagiline mesylate, a new selective monoamine oxidase (MAO) type B (MAO-B) inhibitor, in the treatment of Parkinson's disease.

Methods: A MEDLINE/PUBMED search (1986 through September 2006) was conducted to identify studies involving rasagiline written in English. Additional references were obtained from the bibliographies of these studies.

Ibandronate, an experimental intravenous bisphosphonate for osteoporosis, bone metastases, and hypercalcemia of malignancy.

Ibandronate is an experimental intravenous bisphosphonate under study for the prevention or treatment of osteoporosis and skeletal complications of bone metastases, as well as hypercalcemia of malignancy. To review the data on this drug, PubMed/MEDLINE was searched for pertinent studies in English; data from January 1986-October 2005 were reviewed. In preclinical studies, ibandronate was an extremely potent bisphosphonate compared with its predecessors and was active in all animal models of human postmenopausal and corticosteroid-associated osteoporosis.

Drug forecast: memantine, prototype of a new approach to treatment of dementia.

Objective: To review the first clinically useful N-methyl-D-aspartate (NMDA) inhibitor for the treatment of dementia, memantine.

Data Source: A MEDLINE/PUBMED search was conducted to identify pertinent studies, case reports, letters, and reviews in the English language. All articles published from 1950 to March 2003 were reviewed.

Update on gabapentin therapy of neuropathic pain.

Objective: To provide current information regarding the efficacy and tolerability of the anticonvulsant gabapentin in the management of neuropathic pain.

Data Sources: A MEDLINE search was conducted to identify pertinent studies, case reports, letters, and reviews in the English language published from 1986 through October 2002. Additional references were obtained from the bibliographies of these articles.

A renaissance for fluoxetine in the management of depression in the elderly?

Objective: To review the literature pertaining to the use of the selective serotonin reuptake inhibitor (SSRI) fluoxetine in the management of depression in elders.

Data Sources: A MEDLINE search was conducted to identify pertinent studies, case reports, letters, and reviews in the English language. All articles published from 1986 to 2002 were reviewed.

Daptomycin: the first approved lipopeptide antimicrobial.

Objective: To review the literature concerning the first Food and Drug Administration-approved lipopeptide antimicrobial, daptomycin.

Data Sources: A PUBMED search was conducted to identify pertinent English-language journal articles between 1985 and November 2003, and additional references were obtained from the bibliographies of these articles. Abstracts from the Interscience Conference on Antimicrobial Agents and Chemotherapy meetings from 1985 through 2003 also were reviewed.

Drug forecast--solifenacin: an investigational anticholinergic for overactive bladder.

Objective: To review a new anticholinergic for overactive bladder undergoing review by the U.S. Food and Drug Administration, solifenacin.

The scourge of sarcoptes: oral ivermectin for scabies.

Objective: To review the use of the oral antiparasitic ivermectin in the treatment of scabies, with an emphasis on its use in the elderly and in long-term care settings.

Data Source: A MEDLINE/PUBMED search was conducted to identify pertinent studies, case reports, letters, and reviews in the English language. All articles published from 1980 to October 2003 were reviewed.