Benzodiazepines Tied to Dementia in Elders

Benzodiazepine drugs are associated with increased risk for dementia, according to a BMJstudy.

The study included nearly 1100 community-dwelling, older adults in France who were free of dementia; 9% were considered new users of benzodiazepines — that is, they began using the drugs after the third year of follow-up.

During the next 15 years, dementia was diagnosed significantly more often in new benzodiazepine users than in nonusers (32% vs. 23%). After adjustment for confounders such as age, diabetes, and depression, new users had a 60% increased risk for dementia. A complementary, nested case-control analysis found a similar increase in risk.

The researchers argue against the idea that benzodiazepine use is simply a marker for other conditions (e.g., anxiety) that are linked to dementia — for example, the association between the drugs and dementia increased after 7 years of use. However, they acknowledge that such a theory cannot be "entirely ruled out."

Newer Oral Anticoagulants Associated with 'Dramatic Increase' in Bleeding After ACS

When used to prevent thrombotic events after an acute coronary syndrome, the newer oral anticoagulants (for example, apixaban, dabigatran, and rivaroxaban) are associated with increased rates of major bleeding that offset their antithrombotic benefit, according to anArchives of Internal Medicine meta-analysis.

Researchers examined seven randomized controlled trials comprising over 30,000 patients who were hospitalized with ACS and received antiplatelet therapy. Compared with placebo recipients, those on new-generation oral anticoagulants had "a dramatic increase in major bleeding events." Significant (but moderate) reductions in the risks for stent thrombosis and other ischemic events were seen, but there was no significant effect on overall mortality.

An editorialist concludes that routine use of these drugs in patients with ACS "is unwarranted."

Acute coronary syndrome is a term used for any condition brought on by sudden, reduced blood flow to the heart.

OTC Topical Pain Relievers Pose Burn Risk

Over-the-counter topical muscle and joint pain relievers containing capsaicin, methyl salicylate, or menthol (e.g., Bengay, Icy Hot) may cause serious chemical burns, according to the FDA.

A review of two adverse drug event databases, as well as the medical literature, found 43 reports of burns linked to these products. Those containing menthol were the most likely to cause second- and third-degree burns.

The FDA advises clinicians to warn patients about the burn risk and to provide guidance on using the products appropriately. In particular, the pain relievers should not be applied to broken or damaged skin; the area should not be bandaged tightly; and heating pads should not be used.

Adverse events linked to these pain relievers should be reported to the FDA's MedWatch program, the agency says.