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P&T® Journal contents for January 2008

Features

The authors describe a study in which “bipolar families,” compared with families without a serious mental illness, incurred much higher medical costs, visited physicians more often, had more hospital stays, and spent more money on prescription­ drugs.
Mary Lou Chatterton, PharmD, Xiongkan Ke, MS, Barbara Edelman Lewis, PhD, MHA, Krithika Rajagopalan, PhD, and Arthur Lazarus, MD, MBA
Case Report
Second-generation atypical antipsychotic drugs carry a lower risk of extra­pyramidal symptoms and tardive dyskinesia compared with conventional agents, but they are not without their dangers. The case report of a 46-year-old patient demonstrates the point that the newer agents should be used according to their FDA-approved indications, when possible, and that patients using aripiprazole, an “atypical atypical” agent, need to be carefully monitored.
Thomas Schwartz, MD, and Shafi Raza, MD
Although the “vaccine revolution” has resulted in products that can prevent illness­ and reduce costs of disease, the authors raise several concerns: who will pay for these improvements, how these advances will alter treatment, how cost and efficacy will be balanced, and how to choose the right product.
Jonathan A. McCullers, MD, and Jeffrey D. Dunn, PharmD, MBA
Meeting Highlights
Presentations cover a number of clinical trials of cardiac agents, including clopidogrel­ versus prasugrel; an investigative thrombin receptor antagonist; a niacin/simvastatin­ combination; warfarin dosing versus genotype-guided dosing; clopidogrel eptifibatide, and bivalirudin; and eptifibatide versus abciximab.
Walter Alexander
Topics include nilotinib (Tasigna Capsules) for the treatment of chronic mye­logenous leukemia (CML), raltegravir (Isentress) for patients with HIV-1 infection, and ixabepilone (Ixempra), combined with capecitabine (Xeloda), for use in metastatic or locally advanced breast cancer.
Marvin M. Goldenberg, PhD, RPh, MS
Editor’s Memo
We know you’re as sick of the word “change” as we are, but like many clichés, it serves its purpose. Oh, and by the way, P&T is going digital.
Sonja Sherritze
Given the association between the use of aprotinin (Trasylol) and an increased risk of adverse events among cardiothoracic surgery patients, in contrast to a lack of elevated risk for aminocaproic acid and tranexamic acid, the authors suggest that hospitals examine their current patterns of use and perhaps restrict aprotinin for these patients to prevent major blood loss.
Karl Matuszewski, MS, PharmD; Robert Schoenhaus, PharmD; Mary Ellen Bonk, PharmD; James Lane, PharmD; and Michael Oinonen, PharmD, MPH
The authors describe a study in which they sought to determine whether ­standard practice guidelines for the care of patients with VTE were being ­followed at their VA center.
Cristin Williams, PharmD, Ji Koo, PharmD, and Jonathan Hass, PharmD
Meeting Highlights
Presentations cover lenalidomide (Revlimid) in the treatment of multiple myeloma, eculizumab (Soliris) for paroxysmal nocturnal hemolysis, RAD001 (Everolimus) for lymphoma, the use of deferasirox (Exjade) in patients with iron overload, and dasatinib (Sprycel) and nilotinib (Tasigna) for chronic myelogenous leukemia.
Walter Alexander
Topics include sapropterin dihydrochloride tablets (Kuvan) for reducing phenyl­alanine levels in patients with phenylketonuria; nebivolol (Bystolic) for hyper­tension; and a starch infusion (Voluven) to prevent decreased blood volume ­during surgery.
Marvin M. Goldenberg, PhD, RPh, MS
Opinion
Walter L. Way, RPh, MD, and Fred S. Mayer, RPh, MPH
Meeting Highlights
Presentations cover a short course of treatment with capecitabine (Xeloda), docetaxel (Taxotere), and trastuzumab (Herceptin); a study of the aromatase inhibitors letrozole (Femara) and zoledronic acid (Zometa) and their effect on bone loss; the aromatase inhibitors and tamoxifen (Nolvadex); and a trial of capecitabine plus ixabepilone (Ixempra) compared with ixabepilone monotherapy.
Walter Alexander
Topics include two new agents: ciclesonide (Alvesco Inhalation Aerosol) for the maintenance treatment of asthma and etravirine (Intelence) for adults with HIV infection. A new indication for colesevelam (Welchol) to improve glycemic control in type-2 diabetes is also discussed.
Marvin M. Goldenberg, PhD, RPh, MS
The authors conducted a study to determine whether patients who were not using insulin were following guidelines for self-monitoring of blood glucose. After a new software package was implemented at their institution, the reduced number of excess test strips led to cost savings and improved compliance.
Anita D. Patel, BA, PharmD; Viktoria Kharlamb, PharmD; Arthur P. Reiter, BS, MS; and Ron Lovly, MS, RPh
Continuing Education Credit
The authors describe the pathophysiology and pharmacotherapy of a common complication of diabetes that causes significant morbidity and mortality.
Erin L. St. Onge, PharmD, and Shannon A. Miller, PharmD
Topics include Medicare Part D, informatics, and the paper edition of P&T.
Jacob Hutti, PharmD; Joseph A. Catapano, MD, FACC, MMM; and Teri Luebbering, RPh, CGP, FASCP
Health Care & Law
Dr. Field presents the case for and against the FDA’s proposed new limits for pharmaceutical manufacturers in marketing and promoting off-label uses of drugs.
Robert I. Field, JD, MPH, PhD
Presentations cover comparisons of daptomycin (Cubicin for Injection) and ­vancomycin (Vancocin) for skin infections and recombinant human thrombin ­versus bovine-derived thrombin for controlling hemostasis during surgery.
Walter Alexander
Topics include desvenlafaxine (Pristiq) for major depressive disorder in adults; rilonacept (Arcalyst) in treating inflammatory syndromes; and levocetirizine (Xyzal Oral Solution) for symptoms associated with allergic rhinitis and hives.
Marvin M. Goldenberg, PhD, RPh, MS
Continuing Education Credit
The authors discuss current and investigational therapies for this debilitating­ ­illness, the adverse events associated with its treatment, and some ­protocols for preventing stroke and infection.
Uche Anadu Ndefo, PharmD, BCPS; Angie Eaton Maxwell, PharmD; Huong Nguyen, PharmD Candidate; and Tochukwu L. Chiobi, PharmD

Departments

Editorial
David Nash, MD, MBA, reviews Better: A Surgeon’s Notes on Performanc­e, a book in which Dr. Atul Gawande asserts that our health care system won’t im­prove­ until we rethink our everyday practices.
David Nash, MD, MBA
Medication Errors
In Part 2 of a two-part series, Matthew Grissinger, RPh, FASCP, details the steps needed for safely prescribing and dispensing patient-controlled­ analgesia (PCA).
Matthew Grissinger, RPh, FASCP
Prescription: Washington
Stephen Barlas discusses how consumers might have access to a number of “behind-the-counter” drugs only after they are counseled by a pharmacist.
Stephen Barlas
From cephipeme to valsartan, P&T presents the latest information about FDA approvals, new indications, recalls, and industry updates.
Drug Forecast
Drs. Colabella and Chagan review dalbavancin (Zeven), a glycopeptide for resistant gram-positive organisms.
Jennifer Colabella, PharmD, and Larisa Chagan, PharmD, BCPS
Editorial
David Nash, MD, MBA, discusses the challenges and benefits of “mobile social networking” in the digital age of constant connectedness and its potential effect on the future of medicine.
David Nash, MD, MBA
Medication Errors
Matthew Grissinger, RPh, FASCP, reports on the problems involved when lidocaine is added to IV potassium chloride.
Matthew Grissinger, RPh, FASCP
Prescription: Washington
Stephen Barlas details the problems that might arise if drug manufacturers are permitted to market drugs for off-label purposes, especially antipsychotic agents, and the concerns of Congress that clinical trials will be lacking to support the new indications.
Stephen Barlas
From aliskiren to Welchol, P&T presents the latest information on FDA approvals, indications, and industry updates.
Drug Forecast
Authors Cromer and Peker review aliskiren (Tekturna) for hypertension.
Julie Cromer, PharmD, and Simona Peker, BS, MS/MLS, MSA, PharmD
Editorial
David Nash, MD, MBA, discusses a new report on the government’s efforts to provide improved health care to diabetic patients.
David Nash, MD, MBA
Medication Errors
Matthew Grissinger, RPh, FASCP, suggests that a traditional evidence-based approach cannot be the only way to promote patient safety; common sense is also essential.
Matthew Grissinger, RPh, FASCP
Prescription: Washington
Stephen Barlas details the FDA’s current problems, including an unstable leadership, a lack of manpower, poor morale, too little research, and critical gaps in scientific expertise and technology.
Stephen Barlas
From alendronate to Simcor, P&T presents the latest information on FDA approvals, recalls, and industry updates.
Drug Forecast
The authors review doripenem (Doribax), a carbapenem antibacterial agent.
Olga Hilas, PharmD, BCPS, CGP; Danielle C. Ezzo, PharmD, BCPS; and Tomasz Z. Jodlowski, PharmD, BCPS