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Latebreakers

Don't leave the future of pharmacy practice in the hands of others. So urged John Gans, executive VP of APhA, at a recent seminar on drug importation and counterfeiting at the Arnold & Marie Schwartz College of Pharmacy and Health Sciences in New York.

ADA: Florida Medicaid reform threatens diabetics CMS pushes Part D help for lower-income folks Single-day Famvir shortens duration of herpes Nurses again top R.Ph.s in ethics poll Longs, Calif. Blue Shield to market Medicare Part D Pharmacists disagree over morning-after pill bill Survey: Physicians, R.Ph.s disagree on OTC statins Study explains higher risk of hypertension in Blacks LTCPA to CMS: Let's discuss rebate disclosure Novartis issues breast cancer drug warning FDA committee supports safety of Daytrana Amgen warns about Aranesp, Epogen Flomax tied to cataract surgery condition FDA approves simplified Kogenate reconstitution Firm seeks reports of Medicare Rx fraud, abuse British R.Ph.s win independent prescribing Part D Web site inflated some Rx prices

There are many ways to reduce Medicaid costs Studiocom announces new Medicare site at CVS.com PharmaCare No. 1 in PBMI customer satisfaction report FDA announces meeting, seeks comments and data Pharmacist guild, Kaiser reach tentative wage agreement Genelex offering senior discount on lifesaving genetic tests Duane Reade replaces CEO with Longs Drug exec

FDA: Don't worry, Tamiflu is safe to use FDA issues asthma advisory Hormones not needed by most menopausal women Long-term care alliance: End Medicare confusion CVS becomes AARP featured employer Experts agree on vitamin D's role in bone health Coalition: Don't use supplements against avian flu

In a move to expand efforts to control hospital-acquired infections, the Pennsylvania Health Care Cost Containment Council (PHC4) recently awarded grants totaling $150,000 to six state hospitals. The hospitals will use the money to implement projects to reduce the number of surgical-site infections, Foley catheter-associated urinary tract infections, ventilator-associated pneumonia and central line-associated bloodstream infections, and ventriculostomy and/ or medically resistant staphylococcus infections, said PHC4 officials.

In a move to expand efforts to control hospital-acquired infections, the Pennsylvania Health Care Cost Containment Council (PHC4) recently awarded grants totaling $150,000 to six state hospitals. The hospitals will use the money to implement projects to reduce the number of surgical-site infections, Foley catheter-associated urinary tract infections, ventilator-associated pneumonia and central line-associated bloodstream infections, and ventriculostomy and/ or medically resistant staphylococcus infections, said PHC4 officials.

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.

DEA proposes hike in fees Novartis recalls three products VA revises co-pay for outpatient drugs E-Rxing initiative requires pharmacy link Baxter to withdraw infusion pump Organon launches DTC campaign for NuvaRing FDA approves dosing change for cholesterol drug Consumer groups file lawsuit over dual eligibles ModernHEALTH acquires BioFusion Euflexxa launched for osteoarthritis knee pain Pharmacies must register to dispense isotretinoin FDA approves new indication for Merck's Invanz King reaches Medicaid settlement Unusual process used in denying OTC Plan B CDC: Provide materials when giving flu shots ASHP urges Medicare patients to choose carefully McKesson shuns secondary Rx sources Drug importation efforts lacking, says GAO California R.Ph.s honor Mayer

The government agency responsible for overseeing the 340B Drug Discount Program again has the power to access data on the drug prices charged to healthcare providers who serve underprivileged communities, following an intervention by Senator Chuck Grassley (R, Iowa).

Having trouble rationalizing the use of popular but off-label critical care agents? A special session at the American College of Clinical Pharmacy's annual meeting explored evidence for the use of vasopressin, Factor VIIa, intravenous proton pump inhibitors, and dexmedetomidine (Precedex, Abbott Laboratories).

How R.N.s view R. Ph.s

An exclusive survey of nurses reveals they hold pharmacists in high regard

Newsbriefs

Hospitals that make use of ForHealth's IntelliFill i.v. system can now package injectable drugs for prescription compounding in Samson Medical Technologies' SmartPak Reservoir Bags. These are sealed plastic bags in a foil overwrap that can contain up to 300 gm of sterile powder. ForHealth Technologies has reached an agreement with Samson to make this possible.

Supporters of the notion that apologies are better than malpractice lawsuits got a boost in late September. Sens. Hillary Rodham Clinton (D, N.Y.) and Barack Obama (D, Ill.) introduced the National Medical Error Disclosure and Compensation (MEDiC) Act to encourage hospitals to apologize after medical errors and negotiate fair compensation.

A new project in mid-Atlantic region hospitals puts the spotlight on reconciling medications for intensive care unit (ICU) and operating room patients. As part of a nationwide "100,000 Lives and Beyond" Collaborative, pharmacists who care for patients in Delaware, Maryland, Northern Virginia, and Washington, D.C., hospitals beginning in January 2006 will have the opportunity to formalize processes for getting a complete and accurate list of each patient's current home medications, including name, dosage, frequency, and route and comparing them to the physician's admission, transfer, and/or discharge orders.

At Sentara Healthcare in Norfolk, Va., an aggressive program borrowed from the nuclear energy industry recently won the health system a prestigious patient safety award. Called "Culture of Safety," the program focuses on what its practitioners call behavior-based expectations (BBEs), or "Red Rules," emphasizing communication and accountability.

With greater responsibility for the pharmacy profession ought to come greater recognition. That was the message at the 10th annual ASHP Conference for Leaders in Health-System Pharmacy held recently in Chicago.

The fast-paced complex environment of a hospital critical care unit presents significant patient safety challenges for healthcare practitioners. High-risk decisions are often made with incomplete patient data, and, because patients require high-intensity care, if something goes wrong, they have a higher risk of getting hurt.

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are on the way out. Not the conditions, which represent one of the most significant causes of hospital-associated morbidity and mortality, but the names. The familiar terms DVT and PE are being replaced with a broader term, venous thromboembolism, or VTE.

Saying it's an exciting time for the use of medications to treat opioid addiction, the federal Substance Abuse & Mental Health Services Administration (SAMHSA) has released a protocol giving details of the clinical pharmacology, screening, treatment matching, and other aspects of recommended use.

According to the National Center for Health Statistics, premature births are at a record high. Combine that fact with the reality of the crowded living conditions in the wake of recent hurricanes and we may have a recipe for respiratory syncytial virus (RSV) disaster this coming season.

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.

Atenolol: Use with caution

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.