Clinical News

Disruptions in influenza vaccine supplies are creating headaches. Faced with one of the lowest stocks of flu vaccine on record, the Centers for Disease Control & Prevention has issued interim guidelines on flu vaccination, prophylaxis, and treatment. CDC recommends that HIV/AIDS patients and seven other high-risk groups be vaccinated against influenza. Patients at highest risk should receive chemoprophylaxis and antiviral treatment under certain circumstances.

Some help for battling the obesity epidemic may be arriving, according to continuing encouraging results for rimonabant (Acomplia, Sanofi-Aventis), not just in helping weight loss but also in improving metabolic risk factors. Other research at this year's American Heart Association 2004 Scientific Sessions, held recently in New Orleans, focused, as well, on metabolic effects of pharmacological agents.

Of the hundreds of posters at this year's Interscience Conference on Antimicrobial Agents and Chemotherapy, only seven featur-ing preclinical antibiotics research worldwide were selected as worthy of mention by the ICAAC program committee in its annual poster summary. Of these, only two were called "outstanding" by expert Steven J. Projan, Ph.D., Wyeth research, who warned in a press briefing, "Fewer and fewer important antibiotics are being developed." Here are the two he recommended for special attention by ICAAC attendees:

Community Care Rx (CCRx), the discount card created by the National Community Pharmacists Association, will pay pharmacists for medication therapy management services (MTMS) to help position the profession as a player when the Medicare prescription drug benefit comes on line in 2006.

Anesthesia awareness-the unexpected cognizance that occurs when anesthesia lightens during surgery-is the subject of a recent Sentinel Event Alert issued by the Joint Commission on Accreditation of Healthcare Organizations. Forty-eight percent of patients who experience awareness report auditory recollections, 48% report being unable to breathe, and 28% report pain-without being able to communicate this to the surgical team.

A 60-year-old Hispanic man, L.C., is being discharged from your hospital after an episode of gastrointestinal bleeding. Prior to admission he was switched to naproxen 500 mg b.i.d. for his osteoarthritis when rofecoxib (Vioxx, Merck) was taken off the market. Dismissal orders include ongoing medications: metformin 850 mg b.i.d., pravastatin 40 mg q.d., ramipril (Altace, Aventis) 10 mg q.d., now with the addition of lansoprazole (Prevacid, TAP) 30 mg q.d. L.C.'s physician is in a quandary about whether to prescribe a different COX-2 inhibitor or an NSAID. Previously, L.C. failed to obtain pain relief from acetaminophen or salsalate therapy. What do you recommend?

Nationwide drug shortages, many of which are caused by manufacturing problems, often leave hospital-based healthcare professionals in a bind. A few years ago, when Wyeth-Ayerst announced the imminent unavailability of hyaluronidase (Wydase), it sent shock waves throughout the hospital community.

Chest pain is exceeded only by abdominal pain as the reason people visit their local emergency department. The American Heart Association (AHA) estimates that 6.8 million Americans have chronic stable angina (CSA). In 1999, the American College of Physicians (ACP) and the American College of Cardiology (ACC) and AHA developed joint guidelines on the management of patients with CSA. ACC/AHA updated these guidelines in 2002, and ACP recognized the document as a scientifically valid, high-quality review of the evidence and background paper.

A: Dyslipidemia is a well-known risk factor for coronary heart disease (CHD). Although decreasing low-density lipoprotein cholesterol (LDL-C) levels has long been the primary objective of the management of this disorder, emphasis has also been placed on finding new therapeutic targets as a means to further decrease cardiovascular risk, including agents that raise high-density lipoprotein cholesterol (HDL-C). Low HDL-C, which was previously defined as < 35 mg/dl but recently changed to < 40 mg/dl, is classified as a major risk factor for CHD, whereas high HDL-C (? 60 mg/dl) is beneficial and considered a negative risk factor.

According to the American Heart Association, between 600,000 and one million Americans are affected by deep vein thrombosis (DVT) annually. As many as 200,000 will die of pulmonary embolism (PE), which is more than from breast cancer and AIDS combined.

Obesity, atrial fibrillation/flutter, and diabetic nephropathy, which are clearly on the rise worldwide, were the key areas of attention at the European Society of Cardiology 2004 annual meeting, held in Munich, Germany, recently.

In 2004, one of the National Patient Safety Goals released by the Joint Commission on Accreditation of Healthcare Organizations focused on improving safety when using high-alert medications, such as paralytic agents.

Trying to protect their ability to compound veterinary drugs, 10 pharmacy owners in six states have filed a federal lawsuit against the Food & Drug Administration for banning the use of bulk ingredients.

Zometa linked to osteonecrosis of the jaw

Breast cancer is the second leading cause of cancer-related deaths in women, second only to lung cancer, and the most common malignancy diagnosed in women. The American Cancer Society (ACS) estimates approximately 215,990 women will be diagnosed with breast cancer in 2004. It is estimated that 40,110 women will die from breast cancer in the United States this year alone.

The antipsychotics, SSRIs, should carry stronger warnings for pregnant patients, according to experts.

Here are highlights of the Digestive Disease Week meeting, where studies on drugs for Crohn's disease were presented

Computerized physician order entry reduces prescribing errors but such systems also require advanced clinical decision support and clincial pharmacist involvement, according to a Northwestern Memorial Hospital study of prescribing errors.