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Issue:  February 2012 •  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
   – Prescription
  Photo Statin-Associated Myopathy
This rare but serious adverse event may be dose related.
  Photo Managing Heart-Related Complications in Patients With Diabetes
Cardiovascular problems are common and a major cause of death in patients with this metabolic disorder.

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Editor's Notebook
Cruisin' for Drugs

Pharmacists should advise patients to be wary of counterfeit drugs being sold on the Internet and in foreign "drug stores."
Counseling Pearls
Photo The Pharmacist's Role in Antiplatelet Therapy

A fair number of patients requiring these agents delay filling their prescription or stop taking the medication. Pharmacists should be involved in the patient's therapy continuum and transition from inpatient to outpatient care.
Photo Hypotension: Postprandial and Orthostatic

Both of these forms of low blood pressure have additive, rather than synergistic, mechanisms. A change in cardiac output or pulmonary vascular resistance can cause this condition.
It's the Law
Duty to Warn With No Directions for Use

It's time to end the confusing practice of putting "Use as directed" on prescriptions.
Clinical Corner
Photo Pharmacologic Management of Stroke

Drug treatment depends upon whether the condition is ischemic or hemorrhagic. Ischemic stroke is more common, accounting for 85% to 87% of cases.
Photo Impact of an Inpatient Anticoagulation Monitoring Program

Management of anticoagulation traditionally has been considered a physician responsibility. Implementation of a pharmacist/student monitoring program will likely improve patient care for anticoagulated patients on warfarin.
Consult Your Pharmacist
Helping Patients Quit Smoking With Nicotine Replacement Products

Nicotine stimulates the transmission of dopamine in the brain.
Educational Spotlight
Deep Brain Stimulation Surgery for Parkinson's Disease

This procedure can improve symptoms of tremor, rigidity, bradykinesia, and dyskinesia.
Clinical Considerations for the Treatment of H pylori Infection

It is important to develop individualized treatment regimens for afflicted patients.
Fake Avastin Circulating in U.S.
Silver Spring, MD — A counterfeit version of the cancer drug Avastin has been sold to at least 19 oncologists and oncology clinics in this country. Tests of the fake product revealed that the active ingredient in Avastin was missing. The FDA, which is still analyzing the contents of the fake vials, has not received any reports of patient harm. The counterfeit Avastin, which was sold to sites in California, Texas, and Chicago, was imported from Britain and distributed by Volunteer Distribution, a Gainesboro, Tennessee–based wholesaler. The FDA was notified about the fake product by British regulators in December. This and other instances of fake drugs (Lipitor, Viagra, and Alli) in the U.S. may indicate that the drug-counterfeiting is on the increase here.
Prescription Drug Shortages Impact Community Pharmacists
Alexandria, VA Community pharmacists and their patients are increasingly affected by drug shortages, according to the National Community Pharmacists Association (NCPA). A recent NCPA survey of 675 community pharmacists found that shortages result in inability to fill prescriptions, higher acquisition costs, and lack of insurance coverage for alternative drugs, all of which may cause the patient to go without necessary medications. Nearly all respondents experienced a drug shortage in the past 6 months, in many cases daily or weekly, and 80% said that the shortages last, on average, 3 weeks or longer. About 80% of respondents said that price fluctuations resulted in higher acquisition costs, and about 60% stated that health plan/pharmacy benefit manager reimbursements were not updated to reflect increased costs.
Antibiotics Ineffective for Most Sinus Infections
St. Louis, MO — Antibiotics typically prescribed for sinus infections are not better than placebo at reducing symptoms, according to a Washington University School of Medicine study of 166 patients. At any point from baseline to 28 days afterward, there was no difference in symptom improvement between patients receiving amoxicillin and those receiving placebo. Researchers suggested that, instead of giving antibiotics, clinicians should treat symptoms, such as pain, congestion, and cough, and employ watchful waiting to see whether further treatment is needed. "Patients don't get better faster or have fewer symptoms when they get antibiotics," said Jay F. Piccirillo, MD, senior study author. "Antibiotics aren't necessary for a basic sinus infection—most people get better on their own."
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