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P&T® Journal contents for January 2010

Features

Q&A
In the third of a three-part series, topics such as drug approvals and shortages, therapeutic interchanges, and pharmacoeconomic assessments are discussed.
C. Lee Ventola, MS
An order form for subcutaneous insulin was created to improve blood glucose control in hospitalized diabetic patients. Although use of the form by the staff was relatively low, teaching health care personnel about hyperglycemia and proper use of the form may help reduce complications after patient discharge.
Sally A. Arif, PharmD, BCPS; and Alisa K. Escaño, PharmD, BCPS, CDE
Postoperative ileus is common after surgery, especially abdominal procedures. In clinical studies, alvimopan appeared to speed up gastrointestinal tract recovery, was associated with fewer adverse effects, and led to shorter hospital stays.
Michael Kraft, PharmD, BCNSP; Robert MacLaren, PharmD; Wei Du, PhD; and Gay Owens, PharmD
Meeting Highlights
Sessions covered the ARBITER 6-HALTS trial of ezetimibe (Zetia) and niacin (Niaspan); the HEAAL study of losartan (Cozaar); the relationships between statins, high-density lipoprotein-cholesterol (HDL-C) levels, and cardiovascular events; and the association of higher HDL-C levels with lower rates of breast cancer.
Walter Alexander
Topics include ecallantide (Kalbitor) for hereditary angioedema; a capsaicin 8% patch (Qutenza) for pain management; and romidepsin (Istodax) for patients with cutaneous T-cell lymphoma.
Marvin M. Goldenberg, PhD, RPh, MS
A retrospective review was conducted to assess the effect of various interventions on inappropriate prescribing of acid-suppressive agents in the hospital. ­Providing educational lectures was helpful, but adding a pharmacist to the health care team resulted in the greatest decline in inappropriate use of these drugs.
Randolph E. Regal, BS, PharmD; Amanda D. Osta, MD; and Vikas I. Parekh, MD
Implications for Prescribing Practice and Therapeutic Interchange
Although low-molecular-weight heparins (LMWHs) have similar antithrombotic effects, they differ in their pharmacological and biochemical profiles. The authors discuss therapeutic interchange programs for currently available LMWHs and the risks to patients when agents are not clinically interchangeable.
Geno J. Merli, MD, and James B. Groce, PharmD
Meeting Highlights
Drugs discussed include dasatinib (Sprycel), nilotinib (Tasigna), and imatinib (Gleevec) for patients with chronic myelogenous leukemia; deferasirox (Exjade) for beta-thalassemia major with iron overload; eculizumab (Soliris) for thrombocytopenia; and romiplostim (Nplate) for myelodysplastic syndromes.
Walter Alexander
Topics include an influenza vaccine (Fluzone High-Dose) to prevent virus subtypes A and B in older patients; von Willebrand factor/coagulation factor VIII complex (Wilate) to treat spontaneous and trauma-induced bleeding in patients with von Willebrand’s disease; and tranexamic acid (Lysteda) for heavy menstrual bleeding.
Marvin M. Goldenberg, PhD, RPh, MS
Commentary
Industry’s Agenda Is Clear, but Its Future Path Is Not
Pharmacists are divided over provisions in the House and Senate health care reform bills, but most agree on the need to expand medication therapy management services, reduce patient readmissions, and provide access to discounted drugs.
Stephen Barlas
Rituximab prolongs survival in patients with aggressive lymphomas, but more study is needed to clarify its effect on survival of patients with indolent lymphomas.
Efrat Dotan, MD, Charu Aggarwal, MD, MPH, and Mitchell R. Smith, MD, PhD
Meeting Highlights
Representative studies focus on aromatase inhibitors, tamoxifen, and bisphosphonates. Agents for pancreatic, colorectal, and gastric cancers are also reviewed.
Walter Alexander
Topics include agents for multiple sclerosis, rheumatoid arthritis, and hypertension.
Marvin M. Goldenberg, PhD, RPh, MS
Continuing Education Credit
Applying the 2010 Joint Commission Patient Safety Goal Requirements
Ensuring continuity of care for patients needing erythrocyte-stimulating agents helps to prevent hemoglobin fluctuations, avoids duplications, and lowers hospital costs.
Shilpa Amara, PharmD, Indu Lew, PharmD, and Robert T. Adamson, PharmD
Five medications have been approved for use in patients with Alzheimer’s disease; nonetheless, there remains an urgent need for new and effective drugs. This article describes the role of these agents, with an emphasis on their efficacy, effectiveness, costs, and associated controversies.
David A. Casey, MD, Demetra Antimisiaris, PharmD, and James O’Brien, MD
Hospital administrators are beginning to focus on bar-code scanning as a part of a multi-pronged strategy to reduce medication errors. The experience with bar-coding technology at four medical institutions is described.
Cindy H. Dubin
Blog Watch
Caveat Emptor! (and Other Advice from Cyberspace)
The decades-old debate over generic versus brand-name drugs, once mainly the stuff of medical journals, is now a hot topic on the blogosphere as well. The author provides a sampling of postings from bloggers.
Miriam Reisman
Topics include liraglutide injection (Victoza) for type-2 diabetes; Prevnar 13 vaccine for protection against invasive pneumococcal diseases in children; and olmesartan medoxomil (Benicar) for children with elevated blood pressure.
Marvin M. Goldenberg, PhD, RPh, MS
Continuing Education Credit
Clinical Considerations for the Health System Pharmacist
Targeted therapies are improving outcomes in patients with colorectal, non–small-cell lung cancer, and pancreatic cancer. The authors evaluate the efficacy of these agents and suggest strategies for preventing and managing adverse effects from these treatments to ensure optimal patient care.
Dwight D. Kloth, PharmD, FCCP, BCOP; Lew Iacovelli, BS, PharmD, BCOP, CPP; Rebecca Arbuckle, MS, RPh; and Angela C. McIntosh, PhD
Commentary
Emphasis on Preventive, Holistic Therapies Offers Possibilities for Pharmacists
The passage of the Patient Protection and Affordable Care Act represents an opportunity to begin repairing parts of our health care system. For example, pharmacists might be able to expand their scope of practice and become more involved with patients and prescribers. However, several roadblocks, including a lack of funding and some ambiguous congressional language, must first be overcome.
Stephen Barlas

Departments

Editorial
David B. Nash, MD, MBA, discusses his medication quality subcommittee’s annual assessment of its progress in promoting drug safety.
David B. Nash, MD, MBA
Medication Errors
Tips for Increasing Error Reporting
Matthew Grissinger, RPh, FASCP, provides suggestions to improve error-reporting systems.
Matthew Grissinger, RPh, FASCP
Prescription: Washington
FDA Tries to Clarify Rules for Internet Advertising
Stephen Barlas discusses the FDA’s attempt to clarify the rules on Internet advertising of drugs and medical devices.
Stephen Barlas
From Agriflu vaccine to Zyprexa, P&T presents the latest studies and information about FDA approvals, drug indications, product recalls, and industry updates.
Drug Forecast
Dr. Martin Cruz reviews vigabatrin (Sabril), a therapy for seizure disorders.
Martin P. Cruz, PharmD, CGP, BCPP
Editorial
David B. Nash, MD, MBA, ­discusses the impact of health care reform on academic departments of medicine and their affiliated training programs.
David B. Nash, MD, MBA
Medication Errors
Matthew Grissinger, RPh, FASCP, explains how to ensure safety and minimize risks when oral tablets need to be split.
Matthew Grissinger, RPh, FASCP
Prescription: Washington
Stephen Barlas discusses the FDA’s plans to simplify the labeling of consumer medical information.
Stephen Barlas
From Actemra to Wilate, P&T presents the latest studies and information about FDA approvals, drug indications, product recalls, and industry updates.
Drug Forecast
Dr. Avena-Woods and Dr. Hilas review febuxostat (Uloric) for the treatment of gout.
Carmela Avena-Woods, PharmD, and Olga Hilas, PharmD, MPH, BCPS, CGP
Editorial
David B. Nash, MD, MBA, ­discusses an online application that provides important information linking CME, performance improvement, and maintenance of board certification.
David B. Nash, MD, MBA
Medication Errors
Matthew Grissinger, RPh, FASCP, explains how to prevent the accidental infusion of breast milk in newborns.
Matthew Grissinger, RPh, FASCP
Prescription: Washington
Stephen Barlas discusses how the FDA’s upcoming guidelines for a Risk Evaluation and Mitigation Strategies program could cost hospitals and their pharmacies significant time and money.
Stephen Barlas
From Afluria to Xiaflex, P&T presents the latest studies and information about FDA approvals, drug indications, product recalls, and industry updates.
Editorial
David B. Nash, MD, MBA, discusses the importance of engaging patients in their own health care.
David B. Nash, MD, MBA