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Issue:  February 2011 •  Archive  •  Subscribe •  Unsubscribe
In This Edition Featured Article Featured CE
•  Editor's Notebook
•  Counseling Pearls
•  It's the Law
•  Clinical Corner
•  Consult Your Pharmacist
•  Educational Spotlight
•  Quick Poll
       - Drug Shortages
  Photo Warfarin and Beyond: An Update On Oral Anticoagulation Therapy
A number of alternatives to this widely used drug are available or under investigation.
  Photo Educating Community Pharmacists About Stroke Risks and Primary Stroke Prevention
The public must be advised of risk factors, preventive care, and the need for emergency care for this disease.

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Editor's Notebook
If We Can Land a Man on the Moon, Why Can't We Cure Cancer?

A richly detailed new book provides insight into the intricacies of this complicated disease.
Counseling Pearls
Photo Implementing Lifestyle Medicine in Hypertensive Patients

Lifestyle-medicine strategies (nondrug interventions such as diet, exercise, smoking cessation, and stress management) have been shown to be effective in the prevention and treatment of most chronic conditions.
Photo Calcium Supplementation and Cardiovascular Risk

Conflicting evidence has been published to support both the cardiovascular benefits of and the risks associated with calcium intake.
It's the Law
No Punitive Damages for Ordinary Negligence

Plaintiffs in pharmacy malpractice cases have begun with increasing frequency to ask for extra money designed to punish the defendants for their conduct.
Clinical Corner
Photo The Safe and Appropriate Use of Thrombolytics in the Emergency Department

A significant bleeding risk is associated with this therapy. Despite specific criteria for these agents, eligibility, dosing, and administration errors may occur.
Photo Acute Pericarditis

Inflammation can cause excess fluid to accumulate around the heart, compromising its normal functioning. A variety of infectious and noninfectious causes may be responsible.
Consult Your Pharmacist
Nonprescription Products and Heart Warnings

A great many OTC products advise against medically unsupervised use in patients with heart disease or hypertension.
Educational Spotlight
Review and Management of Common Nonmotor Symptoms of Parkinson's Disease

Issues such as depression, cognitive impairment, GI disorders, and orthostatic hypotension are often overlooked.
Over-the-Counter Use of Neuroactive Peptides for the Treatment of Chronic Pain

Snake venom extracts provide a longer duration of pain relief than traditional analgesics.

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Amphetamine Use May Increase Parkinson's Risk
Oakland, CA— Amphetamines such as Dexedrine and Benzedrine, which are used to treat attention-deficit hyperactivity disorder, narcolepsy, and traumatic brain injury, may put patients at increased risk for developing Parkinson's disease (PD). Research conducted by Kaiser Permanente Northern California found that 1,152 subjects who were studied between 1964 and 1973 and reevaluated in 1995 had been diagnosed with PD by the end of the study. Subjects who took Dexedrine or Benzedrine were almost 60% more likely to develop the disorder, although no increase in risk was found for those who used the drugs for weight loss. Study author Stephen K. Van Den Eeden noted that "amphetamines affect the release and uptake of dopamine, the key neurotransmitter involved in [PD]." There are also implications for illicit drug use.
Most Estrogen in Drinking Water Not From the Pill
Oakland, CA— Contrary to popular belief, less than 1% of estrogens found in U.S. drinking water comes from birth control pills, according to a report published in the American Chemical Society's journal Environmental Science & Technology. An analysis of studies on the topic suggests that other sources are responsible for most of the sex hormone—a source of concern as an endocrine disruptor with possible adverse effects on humans and wildlife—in water supplies. The researchers, who noted that sewage-treatment plants remove virtually all of the 17-alpha-ethinylestradiol (EE2) in oral contraceptives, determined that EE2 has a lower predicted concentration in U.S. drinking water than natural estrogens from soy and dairy products and untreated animal waste used as farm fertilizer. They also found that all people—not just women taking the pill—excrete hormones in their urine.
NCPA Issues Statement on Senate Vote to Repeal 1099 Tax Reporting Provision
Alexandria, VA— National Community Pharmacists Association (NCPA) Executive Vice President and CEO Kathleen Jaeger issued a statement on the Senate's passage of an amendment repealing a provision of the Patient Protection and Affordable Care Act (PPACA) that expanded 1099 tax reporting requirements for businesses purchasing goods and services exceeding $600. "Community pharmacists...have to devote an inordinate amount of their time to administrative tasks," stated Jaeger. "While the [PPACA] included some bipartisan provisions promoting patient access to pharmacy services, a major flaw is the 1099 tax reporting provision, which further shifts community pharmacists' responsibilities from the clinical to the clerical....Full compliance with this requirement would prove daunting for independently owned pharmacy small businesses with limited staff and financial resources. Most importantly, our patients would suffer because the pharmacists would have less time to spend with them providing invaluable prescription drug services and counseling."
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