How Alcohol Affects Newborns, Farxiga for Heart Failure, CCBs and Diuretics

Alcohol and Tobacco and Baby's Brains

Though it’s general knowledge that you shouldn’t drink or smoke when pregnant, there’s a surprisingly low number of studies — just three — that explore the effects that alcohol and tobacco have on a newborn’s brain. Though they’re not surprising, the results of the study are, without a doubt, important knowledge.

A new heart failure drug approved by the FDA is proven effective but also has some disturbing side effects, and patients taking calcium channel blockers are also being prescribed diuretics for the wrong reasons.

Mothers’ Tobacco and Alcohol Use on Newborns

From June 2018 to June 2019, 1,739 newborn babies were examined to study the effects of prenatal exposure to alcohol (PEA) and prenatal tobacco exposure (PTE) on the brain development of newborns. Fewer than 30% of women abstained from both smoking and drinking.

Newborn baby brain activity was recorded using an EEG. The findings indicate that both alcohol and tobacco affect different frequencies of brain waves, pushing them outside of the normal ranges. The findings were not conclusive and only measured newborns. What’s more, the effects of the substances in the long term were not measured in this study.

So, for now, the advice to avoid both alcohol and tobacco during pregnancy seems the safest way to a healthy baby.

Association Between Prenatal Exposure to Alcohol and Tobacco and Neonatal Brain Activity – JAMA May 12, 2020

Farxiga and Heart Failure 

On May 5, 2020, the FDA approved Farxiga (dapagliflozin) for adults with heart failure severe enough that the heart pumps out less than 40% of the blood in the chamber on each beat (called reduced fragment ejection).

Farxiga is also FDA-approved to help improve glycemic control in type-2 diabetics (along with diet and exercise).

In a randomized, double-blind, placebo-controlled study, a total of 4,744 patients were divided into two groups — one took a placebo and the other half took 10 milligrams of Farxiga. After 18 months, the Farxiga group had fewer cardiovascular deaths, hospitalizations due to heart failure, and urgent heart failure visits compared to the control group.

Possible side effects of Farxiga are known because of its use with type-2 diabetes. They include:

  • Dehydration
  • Urinary tract infections
  • Yeast infections
  • Kidney problems (specifically in the elderly)
  • Necrotizing fasciitis of the perineum, aka Fournier’s Gangrene

FDA approves new treatment for a type of heart failure – FDA Press Release

Blood Pressure Drugs 

It turns out that taking CCBs (or calcium channel blockers) may lead to a cascade of unnecessary prescriptions, a population-based cohort study found.

In older populations taking CCBs for hypertension, the study found a 1.4 percent increase in the dispensing of diuretics 90 days within taking CCBs. CCBs can cause swelling in limbs (peripheral edema). Prescribing a diuretic would indicate the symptom was misdiagnosed as a new medical condition and not a side effect of the CCBs.

Diuretics have their own set of side effects which include: too little or too much potassium in the blood, headaches, dizziness, and in serious cases, allergic reactions, kidney failure, and irregular heartbeat.

Awareness among clinicians about CCB side effects needs to be raised to avoid prescribing unnecessary drugs. Whenever a new symptom appears, be sure to remind your health care provider of all medicines you are taking so that side effects can be considered.

Evaluation of a Common Prescribing Cascade of Calcium Channel Blockers and Diuretics in Older Adults With Hypertension – JAMA, Feb 24, 2020