Dr. Stefanacci explains the new rules for Medicare’s Part D drug benefit for the year 2007 and offers strategies for reducing out-of-pocket expenses for beneficiaries.
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P&T® Journal contents for January 2007
Augmentation and Combination Pharmacotherapy Trends in Major Depressive Disorder: Results of a Brief Survey of Psychiatrists
The authors present the results of a brief audience participation survey of 601 psychiatrists about their practices of prescribing antidepressants and discuss the use of first-line, second-line, and third-line treatment options.
Managing Hypertension in Patients with or without Comorbidities in a Teaching Hospital Outpatient Setting
Patients were able to achieve reductions of blood pressure, glycosylated hemoglobin, and low-density lipoprotein-cholesterol, according to the authors, because physicians adhered to national guidelines and spent “quality time” with these patients.
Dr. Goldenberg discusses the current status of targeted therapies for colorectal cancer; novel biologic agents that target angiogenesis and growth factors; a monoclonal antibody for colon and pancreatic cancer; and kinase-targeted drugs for gastrointestinal stromal tumors.
The authors review the cardiovascular risks of commonly used painkillers and present the latest findings on acute myocardial infarction, atrial fibrillation in hypertension, cardiovascular disease in diabetes patients, non–ST-segment elevation in acute coronary syndrome, and familial hypercholesterolemia. The controversial torcetrapib/atorvastatin (Lipitor) combination is also discussed.
Inpatient Economic Burden of Postoperative Ileus Associated with Abdominal Surgery in the United States
A study that was conducted to determine the incidence of postoperative ileus found that this complication was the major cause of delay in the discharge of patients from the hospital, with annual costs totaling $1.46 billion.
Although chronic constipation is a common digestive complaint in North America, physicians and patients have very different definitions of this disorder. The authors discuss the three pathophysiological subtypes; complications; pharmacological therapies and their limitations; as well as the potential impact on quality of life and the economy.
The benefits of telbivudine (Tyzeka) and lamivudine (Epivir-HBV) for the treatment of chronic hepatitis B are compared.
Advances in therapies for seizure disorders are presented, including levetiracetam for elderly patients, carbamazepine for partial-onset seizures in children, pregabalin for refractory epilepsy, vigabatrin for infantile spasms, oxcarbazepine for control of seizure frequency, lacosamide for partial seizures, valproate for status epilepticus and serial attacks, and lamotrigine for tonic–clonic seizures.
The author summarizes the efficacy of two inhaled agents—ipratropium bromide (Atrovent HFA) and tiotropium bromide (Spiriva)—in reducing dyspnea, bronchoconstriction, the frequency of disease exacerbation, and in improving patients’ health status.
Two biologic agents are featured: infliximab (Remicade), which is approved for the treatment of ulcerative colitis, and adalimumab (Humira), indicated for patients with Crohn’s disease.
The author discusses paliperidone (Invega) for the treatment of schizophrenia; telbivudine (Tyzeka) for patients with chronic hepatitis B infection; and a combination of clindamycin phosphate and tretinoin (Ziana Gel) as a topical therapy for acne vulgaris.
Continuing Education Credit
Geriatric depression is often overlooked. The authors review the epidemiology, diagnosis, pathophysiology, and treatment of depression in older adults, with an emphasis on newer pharmacotherapeutic agents.
P&T pays tribute to a long-time columnist and medical writer, Lawrence Prescott, PhD.
As with many well-intentioned feel-good initiatives, achieving the goals of the Medication Reconciliation Project will be a lot more difficult than dreaming them up.
Stimulant drugs, considered a first-line therapy for ADHD, have a potential for misuse and abuse. A new agent may have less potential for these problems.
An Evaluation of Off-Label Use of Recombinant Activated Human Factor VII (NovoSeven): Patient Characteristics, Utilization Trends, and Outcomes from an Electronic Database of U.S. Academic Health Centers
As a therapy for bleeding, rFVIIa is often prescribed for off-label indications, and this trend is increasing. The authors suggest possible new prescribing guidelines.
The author reviews therapies for multiple myeloma, chronic myeloid leukemia, paroxysmal nocturnal hemolysis, and B-cell chronic lymphocytic leukemia.
Although several years have passed since health savings accounts became available to Americans, the number of enrollees has remained relatively low. This article explores some of the pitfalls of the plans and the reluctance of the public to climb aboard.