Community Practice

Reams of articles have been written on when drug treatments should be initiated, but far less literature is available on when they should be discontinued. A recent analysis of Medicare records found that, rather than stopping pharmacotherapy and resorting to hospice care, almost 12% of cancer patients in 1999 received chemotherapy in the last two weeks of life, up 2% from 1983.

The Food & Drug Administration recently granted marketing approval to oxymorphone immediate-release and oxymorphone extended-release tablets (Opana/Opana ER, Endo Pharmaceuticals).

The Food & Drug Administration recently granted accelerated approval to dasatinib (Sprycel, Bristol-Myers Squibb) for the treatment of adults in all phases of chronic myeloid leukemia (CML) with resistance or intolerance to prior therapy-including imatinib (Gleevec, Novartis). The FDA also granted full approval to dasatinib for the treatment of adults with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) with resistance or intolerance to prior therapy. Dasatinib, considered an orphan drug for each of these indications, is currently available in retail pharmacies.

Retailers who fail to comply with a new federal law on methamphetamine can be fined up to $25,000 and jailed for up to two years. Furthermore, if a state or local requirement conflicts with the federal requirement, retailers must comply with the most stringent version. So warned Kevin N. Nicholson, R.Ph., J.D., VP-pharmacy regulatory affairs, National Association of Chain Drug Stores, at the association's Marketplace Conference, held in San Diego recently.

Like an ever-changing emporium, drugstores are showcasing many new OTCs. Here's a peek at the new merchandise.

Pharmacy is on the verge of graduating to a new level of the profession, and it's time for pharmacists to become full partners in the delivery of health care. This was the rallying cry of Cynthia Brennan, newly elected president of ASHP during her inaugural address at the ASHP 2006 Summer Meeting, held in late June in Orlando.

Is technician training pharmacy's next divisive battle? It could be, if major retail employers and state pharmacy boards hold to their present courses.

A new biologic, ranibizumab (Lucentis, Genentech), has just been cleared for age-related macular degeneration (AMD). A study of Medicare patients 65 years of age and older found that AMD increased substantially-from 5% to 27%-between 1991 and 1999. The American Academy of Ophthalmology estimates that more than 1.75 million Americans have AMD, with seven million more having earlier stages of the disease.

The Food & Drug Administration recently granted accelerated approval to dasatinib (Sprycel, Bristol-Myers Squibb) for the treatment of adults in all phases of chronic myeloid leukemia (CML) with resistance or intolerance to prior therapy-including imatinib (Gleevec, Novartis). The FDA also granted full approval to dasatinib for the treatment of adults with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) with resistance or intolerance to prior therapy. Dasatinib, considered an orphan drug for each of these indications, is currently available in retail pharmacies.

Despite the accelerating rate of HIV and AIDS on every continent, "only 12% of people in need of antiretroviral therapies in low- and middle-income countries are receiving them," said United Nations Secretary-General Kofi Annan in an opening address at a high-level conference on AIDS, held recently in New York. Thus, with treatment and prevention efforts being dubbed by Annan as "insufficient," Prezista (darunavir, Tibotec Therapeutics), the new protease inhibitor (PI), is being launched into an HIV market fraught with problems such as drug accessibility shortfalls and drug-resistant HIV.

Just a few years ago switching to a generic drug without consulting a physician or discussing it with the patient was a rare thing for a pharmacist to do. But the times are a-changin'.

Armed with a plethora of OTC test kits, consumers are taking do-it-yourself screenings to new heights

Armed with a plethora of OTC test kits, consumers are taking do-it-yourself screenings to new heights

CollaGenex Pharmaceuticals received approval from the Food & Drug Administration in late May to market Oracea. According to the company, this is the first systemically delivered treatment for the treatment of rosacea. Affecting an estimated 14 million adults in the United States, rosacea is a dermatological condition characterized by papules and pustules, erythema, and telangiectasia.

The integration of patient-controlled analgesia (PCA) technology with devices that continuously monitor oxygen saturation (SpO2) and end-tidal carbon dioxide (ETCO2) significantly improves patient safety, according to innovators of the integrated safety platform.

A 76-year-old woman, L.R., is seen in your hospital for a hot, painful, red, swollen leg injury. Deep vein thrombosis is ruled out by ultrasound. L.R. is diagnosed with superficial venous thrombosis and compression stockings are prescribed. L.R. maintains her varicose vein problem worsened significantly when she started nisoldipine (Sular, First Horizon Pharmaceutical) for blood pressure control. L.R.'s physician asks you about this possibility. He also asks you to recommend an alternative drug (to nisoldipine) for L.R.'s hard-to-control hypertension. She currently takes valsartan (Diovan, Novartis) 320 mg, hydrochlorothiazide (HCTZ) 50 mg, plus nisoldipine 20 mg/d. Her BP averages 145/90. Her only other medicine is prednisone 2 mg. What do you recommend?

Since cancer is the No. 1 area for drug research, it's no coincidence that more than 400 targeted compounds are in development and scores were touted at the recent annual meeting of the American Society of Clinical Oncology (ASCO) in Atlanta. Below is a sampling of promising new or improved cancer fighters:

USP wants input from healthcare practitioners and other interested parties regarding the proposed revisions.

Most of the affected individuals are older females with hypertension who are being treated with agents known to affect renal perfusion.

When the Governor signed the legislation in May, New Hampshire became, by at least one count, the 41st state to permit pharmacists to enter collaborative practice agreements with physicians. But no one knows for sure how many pharmacists are taking advantage of the professional privilege.

Reflecting the economic consequences of a manpower shortage, the median total compensation of staff pharmacists is pushing six figures, according to the latest survey from Mercer Human Resource Consulting.

McKesson has unveiled a radically different pharmacy franchise model designed to strengthen its independent customers by giving them the clout of a mega-chain in the dog-eat-dog world of managed care.

At the American Academy of Neurology's (AAN) 58th annual meeting in April, new guidelines were released for the diagnosis and treatment of Parkinson's disease (PD). The recommendations were later published in the April 11, 2006, issue of Neurology as four separate practice parameters.

Women now have the option of being immunized against cervical cancer following approval of Merck's Gardasil. Roughly 6.2 million Americans become infected with genital human papillomavirus (HPV) each year, and more than 50% of all sexually active persons become infected at some point. HPV is the most common sexually transmitted infection in the United States. While the body's immune system clears the virus in most women, some go on to develop cervical abnormalities that can lead to cancer. Cervical cancer is the second most common cause of cancer death in women, with roughly 470,000 new cases and 233,000 deaths occurring each year worldwide.

The Food & Drug Administration recently approved three generic versions of simvastatin (Zocor, Merck), the largest-selling drug yet to be opened to generic competition. For the next 180 days, Teva will have exclusive rights to sell the 5-, 10-, 20-, and 40-mg dosages of simvastatin and Ranbaxy will have the rights to sell the 80-mg dosage. In addition, Dr. Reddy's Laboratories will sell all five dosages under an agreement with Merck to be the authorized generic manufacturer of the drug.

In less than a year all pharmacies that submit electronic claims subject to Uncle Sam's rules must have a new National Provider Identifier (NPI). To help the profession get a jump on the mandate, the National Council for Prescription Drug Programs has begun submitting NPI applications on behalf of pharmacies.

Delivering chemo agents intraperitoneally is extending survival

A 28-year-old woman, S.A. (two months' pregnant), is brought to your ER by her husband, who believes she is suicidal. According to your health-system medical records, S.A. was diagnosed with bipolar II disorder several years ago. She was previously treated with lithium and lamotrigine (Lamictal, GlaxoSmithKline) separately but was noncompliant. Her psychiatrist is weighing a mood stabilizer and/or antidepressant therapy during pregnancy. He asks for your recommendation.

Of the thousands of drug studies presented at the recent meeting of the American Association for Cancer Research (AACR) in Washington, D.C., two took center stage as "genuine breakthroughs in colon cancer treatment and prevention." First, international scientists cited the biologic panitumumab (Amgen) for extending progression-free survival in advanced cancer patients. Then they hailed new research on celecoxib's (Celebrex, Pfizer) potential to prevent colon cancer-despite concern about heart-related side effects.