January 2016, Issue 10 Inside This Issue The Link Between Microbiomes and Chronic Disease SSRI Usage During Pregnancy and Ausm Risk | Medicaons That May Cause Memory Loss Does Anxiety Contribute to More Severe Asthma Symptoms? Proton Pump Inhibitors and Magnesium Technology & Innovaon: A Gene-Based Approach to Epilepsy Therapy Government Relaons: Illinois Nursing Pracce Clinical The Post Script The Link Between Microbiomes and Chronic Disease It is recognized that microbiota composion is altered in paents with various chronic inflammatory condions. In addion to gastrointesnal condions, such as Crohn’s disease, ulcerave colis, and irritable bowel syn- drome, microbial imbalance has been associated with psoriasis, both type 1 and type 2 diabetes, and cardiovas- cular disease. The emerging evidence strongly suggests that changes in the gut microbiota play a pivotal role in the regulaon of energy homeostasis and the development and progression of obesity and its associated meta- bolic disorders. It is speculated that potenal therapeuc intervenons would be developed on the basis of a beer understanding of the pathophysiologic implicaons of microflora in body cavies. Although it appears that manipulaon of the gut flora may be an avenue for potenal new targeted therapies, further studies are necessary before introducing them into standard clinical pracce. The hope is that this en- hanced understanding will finally begin to yield results that will improve the management of chronic disorders, autoimmune disease, allergy, and even dental disease in the decades to come. SSRI Usage During Pregnancy and Associated Autism Risk Using selecve serotonin reuptake inhibitors (SSRIs) during the second or third trimester of pregnancy is as- sociated with a heightened risk for ausm spectrum disorder (ASD) in children, according to a JAMA Pediat- rics study. Researchers used data from a populaon-based study of women from Quebec who delivered 145,000 full-term infants. Children were followed unl a mean age of 6.2 years. Of these, 0.72% were diag- nosed with an ASD. Use of any SSRIs during the second or third trimester was associated with increased risk for ASD, compared with no exposure. Use of mulple andepressant classes in mid-to-late pregnancy was also ed to increased risk. The associa- on between ASD and andepressants persisted in a subanalysis of women with a history of depression.
Transcript
January 2016, Issue 10
Inside This Issue
The Link Between Microbiomes and Chronic Disease
SSRI Usage During Pregnancy and Autism Risk | Medications That May Cause Memory Loss
Does Anxiety Contribute to More Severe Asthma Symptoms?
Proton Pump Inhibitors and Magnesium
Technology & Innovation: A Gene-Based Approach to Epilepsy Therapy
Government Relations: Illinois Nursing Practice
Clinical
The Post Script
The Link Between Microbiomes and Chronic Disease
It is recognized that microbiota composition is altered in patients with various chronic inflammatory conditions.
In addition to gastrointestinal conditions, such as Crohn’s disease, ulcerative colitis, and irritable bowel syn-
drome, microbial imbalance has been associated with psoriasis, both type 1 and type 2 diabetes, and cardiovas-
cular disease. The emerging evidence strongly suggests that changes in the gut microbiota play a pivotal role in
the regulation of energy homeostasis and the development and progression of obesity and its associated meta-
bolic disorders. It is speculated that potential therapeutic interventions would be developed on the basis of a
better understanding of the pathophysiologic implications of microflora in body cavities.
Although it appears that manipulation of the gut flora may be an avenue for potential new targeted therapies,
further studies are necessary before introducing them into standard clinical practice. The hope is that this en-
hanced understanding will finally begin to yield results that will improve the management of chronic disorders,
autoimmune disease, allergy, and even dental disease in the decades to come.
SSRI Usage During Pregnancy and Associated Autism Risk
Using selective serotonin reuptake inhibitors (SSRIs) during the second or third trimester of pregnancy is as-
sociated with a heightened risk for autism spectrum disorder (ASD) in children, according to a JAMA Pediat-
rics study. Researchers used data from a population-based study of women from Quebec who delivered
145,000 full-term infants. Children were followed until a mean age of 6.2 years. Of these, 0.72% were diag-
nosed with an ASD. Use of any SSRIs during the second or third trimester was associated with increased risk
for ASD, compared with no exposure.
Use of multiple antidepressant classes in mid-to-late pregnancy was also tied to increased risk. The associa-
tion between ASD and antidepressants persisted in a subanalysis of women with a history of depression.
The Post Script | 2
Clinical
Anxiety sensitivity has been linked to more debili-
tating asthma symptoms and greater functional limita-
tions.
Researchers from the University of Cincinnati studied
101 college undergraduate students with asthma in
order to investigate the relationship between anxiety
and asthma. They found that anxiety sensitivity ampli-
fies your reaction to anxiety symptoms, which are very
similar to asthma symptoms.
The researchers had previously conducted research that demonstrated high levels of anxiety were detrimental to the
management of asthma, and they believed that anxiety made the patients more reactive to their symptoms.
Patients should be encouraged to talk to their doctor about their anxiety or educate them that their anxiety symp-
toms make their asthma worse. Some research on the subject suggests that asthma patients with anxiety use more
medications than their objective lung function may indicate is needed. However, medication intake should be moni-
tored by their health care professional.
Sometimes, it’s hard to tell the difference between asthma symptoms and anxiety symptoms, and for people with
high levels of anxiety and asthma, it might be panic.
January 2016 | Issue 10
Medications That May Cause Memory Loss
Does Anxiety Contribute to More Severe Asthma Symptoms?
The scary side effect of memory loss is a possibility for many commonly prescribed
medications. According to AARP, the following eight drugs and drug classes may cause
memory loss:
1) Benzodiazepines: Antianxiety agents may cause memory loss due to the sedative
effect that they have on certain parts of the brain. Most notably, the drug’s effects
are involved in the transfer of events from short-term to long-term memory.
2) Cholesterol reducing drugs: lowers cholesterol , which is important in learning and memory
3) Antiseizure medications: depress the flow of signals to the central nervous system causing mental bluntness and
memory loss
4) Narcotic painkillers: affects the central nervous system, which may lead to memory loss
5) Drugs to treat Parkinson’s Disease: activate dopamine which may lead to memory loss and fatigue
6) Antihypertensive Drugs: Interfere with epinephrine and norepinephrine, which are messenger chemicals in the
brain
7) Incontinence Medications: block the action of acetylcholine, risking memory loss and cognitive decline
8) Antihistamines: Inhibit the action of acetylcholine, which helps in the thinking process, physical activity and laying
down memories.
The Post Script | 3 January 2016 | Issue 10
The next phase of personalized medicine in epilepsy may be ther-
apy that is tested and targeted to the specific genetic mutation
causing an individual's seizure disorder.
A new genetic research company is the first to pair expertise in
rare disease genomics with advanced analytics to provide
healthcare professionals with an extensive and highly personal-
ized evaluation on individual epilepsy patients.
The aim is to help patients who have already been diagnosed with epilepsy and have undergone sequencing.
Scientists then replicate the mutation that has been identified, characterize it, and test drugs on it.
The company then reports this information back to the treating physician, who will ultimately make the treatment de-
cisions along with the patient.
An estimated 2% to 4% of childhood epilepsies are genetically based. Researchers are discovering more genetic causes
of epilepsies all the time.
Researchers say the advantage of this new initiative is that it incorporates a targeted approach to epilepsy therapy
that accelerates the process of finding an effective therapy.
Technology and Innovation A Gene-Based Approach to Epilepsy Therapy
Clinical Proton Pump Inhibitors and Magnesium
Proton pump inhibitors (PPIs) are currently the main therapy
for gastroesophageal reflux disease, peptic ulcer disease, non-
ulcer dyspepsia, and prevention of gastric erosion with the use
of nonsteroidal anti-inflammatory drugs.
The broad spectrum of indications and the favorable safety pro-
file have made them one of the most frequently used pharma-
ceuticals. Because of their widespread and often long-term use,
the safety of PPIs has received attention since their first intro-
duction. Since 2006, cases of severe hypomagnesemia have been reported in association with the use of PPIs,
sometimes accompanied by secondary hypokalemia and hypocalcemia. Severe hypomagnesemia may result in
tetany, convulsions, or cardiac arrhythmias.
Although mild hypomagnesemia is often asymptomatic, it may still be relevant because population studies have
shown that even mild hypomagnesemia is associated with increased risk of diabetes mellitus, osteoporosis, car-
diovascular disease, and mortality. Cases of severe hypomagnesemia have not been reported with the use of
histamine 2 receptor antagonists (H2RAs), although a recent study showed that their long-term use is also asso-
ciated with hypomagnesemia.
The Post Script | 4 January 2016 | Issue 10
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