Drug and Therapeutics Bulletin

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What you need to know Lecanemab (Leqembi) is a monoclonal antibody that binds to amyloid beta protein aggregates that are thought to be involved in Alzheimer’s disease. It is indicated for treatment of mild cognitive impairment or mild dementia in Alzheimer’s disease in adults who are apolipoprotein E ε4 heterozygotes or non-carriers.

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Introduction Part 1 of this two-part series considered diagnostic criteria,1 non-pharmacological interventions and provided an overview of pharmacological management for adults with attention deficict hyperactivity disorder (ADHD). In this article, I consider medication in more detail.

Pregnancy Primary Health Care Pharmacy Secondary Care In the UK confidential enquiry covering the triennium 2020–2022, the leading cause of maternal mortality with 43 deaths was venous thromboembolism (VTE), with the VTE mortality rate more than doubling since the preceding triennium.1 Maternal deaths from VTE now exceed deaths from other leading causes such as heart disease, epilepsy and infection.

Drug-Related Side Effects and Adverse Reactions Health Care Quality, Access, and Evaluation Gabapentinoids are associated with respiratory depression and medicine regulators have issued safety warnings urging caution when prescribing to those with compromised respiratory function. A Canadian cohort study found that gabapentin and pregabalin use was associated with an increased risk of severe exacerbations of chronic obstructive pulmonary disease .

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Treatment goals Negotiating clear treatment goals with patients (preferably Specific, Measurable, Achievable, Relevant, Timed) may help them to be realistic about what medication can achieve; understanding patients’ priorities may help clinicians determine optimal treatment; and goals can facilitate a ‘measurement-informed approach’ to assess response.

Drug-Related Side Effects and Adverse Reactions Health Care Quality, Access, and Evaluation A recent article published in the BMJ argued that a polypill containing various commonly prescribed cardiovascular medicines should be offered as primary prevention to all people in the UK over the age of 50 years to reduce the risk of heart attacks and strokes.1 The paper, based on discussions at a ‘consensus building seminar’ held in London in 2024, claimed that the introduction of a cardiovascular...