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P&T August 2013

Features

Pharmacovigilance Forum
Seldom considered to be a drug that causes renal problems, diphenhydramine can have adverse effects in some patients, as illustrated by a case study of a middle-aged veteran. Extra precautions are urged before this medication is prescribed, especially in elderly patients.
A Retrospective Chart Review
Noting inappropriate uses of piperacillin/tazobactam at their institution, the authors emphasize the need for antimicrobial stewardship efforts, as well as infection-control practices, to curtail drug resistance, reduce costs, and minimize adverse events.
From Conceptual Development to Real-World Implementation
The authors sought to clarify the relationship between evidence-based medicine and access to drug coverage. They concluded that a structured approach to improving clarity, consistency, and transparency was lacking.
A Retrospective Cohort Study
After kidney transplant recipients who received Prograf were switched to generic tacrolimus, most differences in the safety and effectiveness of the medications were not considered clinically relevant

Departments

Medication Errors
Sharing metered dose inhalers among patients can lead to cross-contamination.
Prescription: Washington
A Senate bill that exempts hospital compounding pharmacies from some rules is stirring debate.

FDA approvals, drug indications, and updates

Canagliflozin (Invokana) for type-2 diabetes; denosumab (Xgeva) for giant-cell tumor of bone; and paroxetine mesylate (Brisdelle) for vasomotor symptoms in menopause

Drug Forecast
Phentermine/topiramate extended-release capsules (Qsymia) for weight loss