USPharmacist.com > May 2011

Issue: May 2011 • Archive

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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 - Allergy Season		Blowing Out Your Knee: ACL Tear and Pain Management One of the most feared sports and work injuries is a torn anterior cruciate ligament.		Treatment Options in Managing Chronic Low Back Pain Therapy should be individualized based on the severity of pain and duration of symptoms.

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Editor's Notebook

The Painful Truth

It’s becoming more difficult to distinguish patients who are abusing opioids from those who have legitimate chronic pain.

Counseling Pearls

When Should Narcotic Bowel Syndrome Be Suspected?

The rapid increase in the use of opioids for chronic noncancer pain over the past decade has exposed larger numbers of people to the wide-ranging side effects of opioid therapy, including opioid bowel dysfunction.

The Pharmacist’s Role in Medication Adherence

The pharmacist needs to be diligent about including the patient in the treatment experience. Nonadherence to medication for chronic diseases leads to worse therapeutic outcomes, higher hospitalization rates, and increased health care costs.

It's the Law

The Prescription Defense

A zero-tolerance policy toward possession of a controlled substance has unintended consequences.

Clinical Corner

The Emerging Role of NMDA Antagonists in Pain Management

By understanding the current role of these agents, pharmacists can impact patient care greatly in individuals who are not receiving adequate pain relief due to opioid resistance and neuropathic pain not adequately controlled by commonly used drug therapies.

The Impact of REMS on Pain Management

The prescribing of opioids has been associated with apprehension and contentious debate in the health care community, which has created barriers to achieving adequate pain relief. Hospitals and pharmacies alike should develop risk evaluation and mitigation strategies.

Evaluating and Treating Chest Pain in the Acute Care Setting

Chest pain is a common occurrence in primary, acute, and urgent care settings, and it is one of the most cited reasons for which people seek medical attention. It is often difficult to discriminate between cardiac and noncardiac causes.

Consult Your Pharmacist

Alleviating Menstrual Discomfort: PMS and Dysmenorrhea

Premenstrual pain and cramping can be treated with nonprescription analgesics.

Educational Spotlight

An Overview of Uveitis and Its Management

Significant vision loss can occur in more than one-third of patients with this condition.

The Prevention and Treatment of Whooping Cough

Pertussis continues to be poorly controlled despite national immunization programs.

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Newswire

Coffee May Lower Risk of Prostate Cancer
Boston, MA— According to the Health Professionals Follow-Up Study from researchers at the Harvard School of Public Health, men who regularly drink coffee appear to have a lower risk of developing metastatic or lethal prostate cancer. Men who consumed six or more cups daily had nearly a 20% lower risk of developing any form of prostate cancer and a 60% lower risk of developing lethal prostate cancer. The reduction in risk was seen whether the men drank regular or decaffeinated coffee and does not appear to be due to caffeine. Coffee contains many beneficial compounds that act as antioxidants, regulate insulin, and reduce inflammation, all of which may influence prostate cancer. In previous studies, coffee consumption has been associated with a lower risk of Parkinson's disease, type 2 diabetes, and liver cancer.

New HIV Treatment Approved
Gaithersburg, MD— The FDA has approved Edurant (rilpivirine) in combination with other antiretroviral drugs for the treatment of HIV-1 infection in adults who are treatment-naïve. The drug is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that is to be used as part of a highly active antiretroviral therapy (HAART) regimen designed to suppress viral load in the blood. Edurant showed efficacy similar to efavirenz, another FDA-approved NNRTI. In two phase III trials of 1,368 patients with HIV, 83% had undetectable amounts of HIV in their blood after 48 weeks of treatment. The most common side effects were depression, insomnia, headache, and rash. The drug is manufactured by Tibotec Therapeutics, a division of Centocor Ortho Biotech Inc.

Access to Rosiglitazone Restricted
Gaithersburg, MD—Health care providers and patients and are now required to enroll in a Risk Evaluation and Mitigation Strategy (REMS) program in order to prescribe and receive rosiglitazone-containing medicines, including Avandia, Avandamet, and Avandaryl. These drugs are used to treat type 2 diabetes. The restrictions are based on data that suggested an elevated risk of heart attacks in patients taking rosiglitazone. The Avandia-Rosiglitazone Medicines Access Program limits the use of rosiglitazone to patients already being treated with these medicines, those whose blood glucose levels cannot be controlled with other antidiabetics, and those who do not want to use pioglitazone-containing medicines (Actos, Actoplus Met, Duetact). Patients enrolled in the REMS program will receive their medication through specially certified mail order pharmacies. After November 18, 2011, rosiglitazone will no longer be available through retail pharmacies.