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A 70-year-old man, P.A., is seen in your ER with burning, stabbing, shooting pain on his lower back. He has recently had shingles; the emergency physician diagnoses his current discomfort as postherpetic neuralgia (PHN). The physician is debating what to prescribe and asks your opinion. You note from the patient's history that P.A. also takes donepezil (Aricept, Eisai) 10 mg, digoxin .125 mg, and benazapril 20 mg daily. What do you recommend?

The panel advised against the use of fluticasone with ritonavir because the combination resulted in significantly reduced serum cortisol concentrations.

Most surgeons misuse antibiotics most of the time. That is the blunt warning from Robert Sawyer, M.D., codirector of the surgical trauma intensive care unit at the University of Virginia Health System. The problem is not ignorance of appropriate use, he told the American College of Surgeons Clinical Congress meeting in San Francisco recently.

The treatment of elevated blood pressure reduces the incidence of stroke and leads to a significant reduction in mortality and morbidity among patients with cardiovascular problems. Although the beta-blockers are among the most widely prescribed medications for blood pressure control, not all hypertensive patients show benefit from taking these drugs.

I recently read a book titled, Dangerous Doses: How Counterfeiters Are Contaminating America's Drug Supply (Harcourt, 2005). It is written by Katherine Eban, an investigative medical reporter who provides a very detailed account of the counterfeiting of drugs and other major problems in the U.S. drug distribution system. Most people have little awareness of the scope of these problems or the potential consequences.

There's some good news for pharmacists adrift in a sea of Medicare Part D confusion: They will be able to electronically determine whether a patient has prescription coverage, and they don't have to keep track of how much beneficiaries have spent out of pocket.

Medical practitioners treating Parkinson's disease (PD) tend to focus on controlling patients' movement disorders. So said Monique Giroux, M.D., medical director of the National Parkinson Foundation Center of Excellence at the Cleveland Clinic Foundation. But for the patient, other disease-related symptoms are sometimes just as troubling as the motor disorders.

Children whose growth falls below the third percentile for their age and gender are said to have "short stature." A variety of factors—including genetics, constitutional delays, and medical conditions—may cause this delay in growth. Children genetically predisposed to short stature typically have a parent of short stature, while children with con-stitutional growth delay may initially exhibit slow growth patterns but experience a rapid growth phase during puberty.

Much is expected to happen on the vaccine front in the next 1,000 days or so, two top vaccine experts told a session at the American Academy of Pediatrics (AAP) conference in Washington, D.C., in October.

More systematic applications of new treatments for Types 1 and 2 diabetes should have a profound effect on glucose control and the complications of diabetes. So said William Herman, M.D., Stefan S. Fajans/ GlaxoSmithKline Professor of diabetes, professor of internal medicine and epidemiology, and director of the Michigan Diabetes Research & Training Center at the University of Michigan Medical Center in Ann Arbor. He spoke at a recent media press briefing in New York City sponsored by the American Medical Association.

R.Ph. appeals punishment for refusal to dispense OCs

Seniors offered Medicare Rx worksheet AANMA: Preferred drug lists interfere with successful asthma control Medco study finds low rate of dispensing errors CARE Pharmacies adds franchises Medicine Shoppe offers nutritious recipes for diabetes patients Study: Omega-3 fatty acids and lutein could help seniors Longs cancels flu shot clinics; FluMist available in some locations McKesson begins second phase of Health Across America tour U.S. has higher healthcare costs, more medical errors

Most see triptans not safe as OTCs FDA mandates digital Rx label submissions OTC pain medications can cause serious stomach problems Rx recall news may negatively impact drug trials AstraZeneca proposes mandatory FDA review of DTC ads Walgreens Home Care to acquire Home Pharmacy of California Salus Corp. recalls shampoo caps Consumers Union to FDA: DTC reforms needed Quigley, NCOA to educate seniors on safe OTC use R.Ph.s protest TennCare Rx cuts FDA approves Trileptal as adjunctive therapy Kaletra tablets get FDA nod NPI supports pertussis vaccination in adults ACIP recommends universal hepatitis A vaccination for children Coalition opposes monopoly protections for brand drugmakers CDC study supports aggressive initiative to combat diabetes Medicare beneficiaries get one free Rx plan change Preliminary vaccination priorities for bird flu announced CIGNA launches depression management program Florida Medicaid to curb benefits CHEC to focus on medicine safety Walgreens opens its 5,000th store NQF publishes report on home healthcare performance standards

A special supplement brought to you in partnership with Wyeth

Most of our patients have no clue what genomics is, much less the ramifications of genetic testing, pre-embryonic stem cell research, and DNA preventive medicines.

McNeil Consumer & Specialty Pharmaceuticals has launched an on-line educational campaign to inform patients of the importance of the proper use and storage of medications and of maintaining a healthy medicine cabinet. The campaign comes on the heels of a recent survey conducted for McNeil by Harris Interactive. The survey found that nearly half (46%) of American adults have taken an expired over-the-counter (OTC) medication.

In the past five years, network TV has brought news of counterfeit pharmaceuticals to the American public at a seemingly increasing rate. Reports about the counterfeiting of drugs such as gentamicin, Lipitor (atorvastatin, Parke-Davis), Epogen (epoetin alfa, Amgen), Procrit (epoetin alfa, Ortho Biotech), and Viagra (sildenafil, Pfizer Inc.) have been big news. The public has seen photos of counterfeit drugs next to authentic agents, their nearly identical appearance graphically demonstrating the counterfeiters' sophistication.

With an increasing number of employers migrating to mandatory mail, mail-order fulfillment is the greatest challenge facing retailers. Retail pharmacies should consider offering 90-day prescription retail programs in order to compete with mail-order plans and to meet customer demand. So said Denise Schultz, R.Ph., director of pharmacy support for Supervalu Pharmacies. She delivered this advice to attendees of the NACDS Pharmacy & Technology Conference, held recently in San Diego.

Now that the water has receded in New Orleans and other gulf coast communities in the aftermath of hurricanes Katrina and Rita, cleanup and rebuilding efforts are virtually just beginning.

Concerned about the potential impact that Medicaid budget cuts will have on health care, the National Association of Chain Drug Stores and the National Community Pharmacists Association have formed the Coalition for Meaningful Medicaid Reform (CMMR).

I belong to the Vermont Pharmacists Association (VPA). It is a fine organization. The officers encourage us to become politically active. The association puts on periodic meetings with interesting CEs and always a great lunch. I'm glad I joined, but I know very well that a small pharmacist group from the second smallest state can have only limited impact.

While American pharmacies are bracing for the onslaught of Medicare Part D, Canadian mail-order operators are worrying that their first and best customers may be lured away by the siren song of the new prescription drug benefit.

Lawmakers crafting the Medicare Modernization Act (MMA) intentionally created incentives favoring the use of formularies based on the premise that competition among manufacturers would lower program cost. CMS subsequently issued regulations about formularies and cost-sharing strategies that would balance the needs of persons with Medicare against the cost-control measures typically imposed by PBMs.

Pharmacists participating in the Community CareRx (CCRx) Medicare prescription drug plan will be paid not only for their clinical expertise but also for their financial advice that helps beneficiaries select the most economical medications that are right for them.

The International Diabetes Federation (IDF) launched the first global evidence-based guidelines for Type 2 diabetes at the September meeting of the European Association for the Study of Diabetes, in Athens.

In a late-stage clinical trial, Merck's investigational quadrivalent human papillomavirus (HPV) vaccine, Gardasil, showed the vaccine is capable of preventing 100% of high-grade cervical precancers known as cervical intraepithelial neoplasia (CIN) as well as noninvasive cervical cancers, such as adenocarcinoma in situ (AIS), associated with HPV types 16 and 18. More than 12,000 women between the ages of 16 and 26 participated in the prospective, randomized, double-blind, placebo-controlled study, know as Future II.

Although estrogen replacement therapy is still the most effective way to manage menopausal symptoms, there is no one-size-fits-all solution. A new option, however, should be available in pharmacies by mid-2006.

Reliant Pharmaceuticals, Liberty Corner, N.J., recently launched Omacor, an omega-3-acid ethyl esters product approved by the Food & Drug Administration in November 2004.