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The Substance Abuse & Mental Health Services Administration (SAMHSA) has issued an alert to healthcare professionals who work with substance abuse patients about a new deadly drug combination being sold on the streets. Fentanyl is being combined with heroin or cocaine and has resulted in more than 100 deaths combined in the cities of Detroit, St. Louis, and Philadelphia since last September.

Gadolinium-containing contrast agents used at high doses may be linked to development of nephrogenic systemic fibrosis or nephrogenic fibrosing dermopathy (NSF/NFD) that occurs in patients with kidney failure. The FDA has learned of 25 cases of NSF/NFD in patients who received Omniscan, a gadolinium contrast agent, and then underwent a magnetic resonance angiography (MRA).

Merck/Schering-Plough Pharmaceuticals has announced the approval of a new indication for Zetia (ezetimibe). The drug can now be used in combination with fenofibrate, along with diet, for the reduction of high total cholesterol and LDL cholesterol in patients with mixed hyperlipidemia, a metabolic disorder consisting of high LDL cholesterol, low HDL cholesterol, and elevated triglycerides.

Effective tobacco cessation interventions are available and could double or triple quit rates, but not enough smokers request or are being offered these interventions. This was a key finding of an NIH panel that convened recently to assess the available scientific evidence on tobacco use prevention, cessation, and control.

The FDA has ordered manufacturers of all unapproved carbinoxamine-containing products to stop producing their offerings over the next 30 to 90 days. The agency has received 21 reports of death in children under two years of age associated with these products.

The Allergy and Asthma Foundation of America (AAFA) will launch a campaign to educate patients and physicians to help ease the transition to hydrofluoroalkane (HFA) inhalers from the less environmentally friendly chlorofluorocarbon (CFC)-containing versions.

The American Medical Association house of delegates has adopted a series of key principles to guide the establishment and operation of store-based healthcare clinics. The following principles are included in the guidelines: store-based health clinics must have a well-defined and limited scope of clinical services, consistent with state scope of practice laws; establish arrangements by which their healthcare practitioners have direct access to and supervision by physicians; and establish a referral system with physician practices or other facilities for appropriate treatment if the patients' condition or symptoms are beyond the scope of services provided by the clinic.

Excelsior College has launched an on-line bachelor's degree in health sciences for pharmacy technicians and other healthcare professionals seeking to advance into related positions in the health science professions. The program offers flexibility so students can continue to work while completing the course work at their own pace, according to the nonprofit distance education college located in Albany, N.Y.

Making sense of Medicare Part D prescription drug plans has been a major challenge for seniors. But for Medicare Part D recipients who have received organ transplants, choosing a plan is the least of their problems.

Pharmacists are playing a key role in medical groups' efforts to manage prescription drug costs, according to a study prepared for the U S. Department of Health & Human Services by Abt Associates, Cambridge, Mass. Lead author Harmon Jordan, Sc.D., told Drug Topics, "Clinical pharmacists are helping to educate physicians and patients, and they're forming relationships with physicians where they seem to have a very synergistic existence."

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.

While most people haven't had time to digest the intricate details of the United States Pharmacopeia's proposed changes to General Chapter 797 (Pharmaceutical Compounding-Sterile Preparations), response to the protracted document has been almost universally positive.

Is it possible to raise public awareness about the value of medications while demonstrating the important role of community pharmacists in maximizing the effectiveness of drug therapy? The Pharmacy Value Alliance (PVA), a coalition of pharmaceutical companies and community pharmacy organizations, thinks so.

Pharmacy may be at a moment of unaccustomed visibility just at a time when the nation's direction is in flux, political commentators told the several hundred pharmacists who went to lobby Washington during the National Community Pharmacists Association's legislative conference last month.

Still reeling from the economic havoc churned up by Medicare Part D's slower and lower reimbursements, pharmacy is bracing for the destruction swirling its way in the form of reimbursement cuts spawned by another monster storm named Medicaid.

She talked with a slur, slowly. I looked at her eyes. They were hooded with droopy lids. There were food stains on her T-shirt. She wore no makeup and this essentially attractive 35-year-old was showing her worst. I had seen her like this before. But she had been doing so well.

Compounding pharmacists who would like to put their practices to the test can now apply to earn the seal of approval offered by the Pharmacy Compounding Accreditation Board (PCAB).

Myelodysplastic syndromes (MDS), a collection of disorders in which the bone marrow does not produce enough mature cells, has received a lot of attention in recent years despite the fact that it affects only about five in 100,000 people. This is due in part to the Food & Drug Administration's approval of several new molecular entities used in its treatment, including azacitidine (Vidaza, Pharmion) in 2004 and lenalidomide (Revlimid, Celgene) in 2005. And just last month the agency approved a third drug, decitabine injection (Dacogen, MGI Pharma).

The Food & Drug Administration recently approved varenicline (Chantix, Pfizer) as an aid to smoking cessation. Varenicline is the first new prescription treatment for smoking cessation to receive FDA approval in nearly a decade and only the second nicotine-free smoking cessation therapy ever approved by the agency. This new molecular entity received priority review because of its potential benefit to public health. Pfizer plans to make the drug available in U.S. retail pharmacies in the second half of 2006-most likely during the third quarter.

The Food & Drug Administration has approved rasagiline (Azilect, Teva) for the treatment of Parkinson's disease (PD). Rasagiline is an irreversible monoamine oxidase type B (MAO-B) inhibitor that blocks the breakdown of dopamine, a chemical that transmits signals between the substantia nigra and other parts of the brain.

Four national pharmacy groups have responded to a commentary on emergency contraception in the journal Obstetrics & Gynecology that argued that R.Ph.s should not be allowed to refuse to dispense medications based on their personal values because they lack the fundamental prerequisites to make clinically sound ethical decisions. APhA, ASHP, AMCP, and ACCP stated their support for a policy that ensures patients get their medications when an R.Ph. steps away from a script based on personal beliefs.

Prescription drug costs will rise 12.2% over the next 12 months, according to a survey of 70 healthcare insurers by Aon Consulting. The projected increase is lower than the 13.1% a year ago.

Washington pharmacists could refuse to dispense emergency contraception but would have to provide patients a "timely alternative," under a policy endorsed by the state pharmacy board. The "refuse-and-refer" policy is opposed by women's and pro-choice groups, as well as Gov. Christine Gregoire.

Out of a total of 19,420 HIPAA complaints lodged since the medical privacy rule went into effect three years ago, the Bush Administration has imposed no fines and has prosecuted just two criminal cases, according to the Washington Post. The most common allegations included that personal medical information was wrongly revealed, information was poorly protected, and proper authorizations were not obtained.

Pennsylvania bill H.B. 814 could increase the state's consumers' and employers' prescription drug costs by as much as $123 million annually, according to new study from the actuarial firm Milliman and released by PCMA. The bill calls for proposed restrictions on consumers' and employers' ability to choose the mail-service pharmacy option and also eliminates co-pay differentials between retail and mail-service prescriptions.

Part D enrollees with mental illness will have to pay up to four times more in out-of-pocket expenses than their privately insured counterparts, according to a study from Thomson Medstat. They will also reach the donut hole in coverage two months earlier than the average for all Medicare patients.