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Issue:  November 2013 •  Archive  •  Subscribe •  Unsubscribe
In This Edition Featured Article Featured CE
•  Editor's Notebook
•  Counseling Pearls
•  TechRx
•  Clinical Corner
•  Consult Your Pharmacist
•  Educational Spotlight
•  Quick Poll
    – Healthcare Exchanges
  Photo DSM-5: Potential Impact of Key Changes on Pharmacy Practice
The new edition includes a number of changes to the classification of mental health disorders.
  Photo Issues and Data Associated With Addictive Disease in Pharmacists
Pharmacies can present a precarious environment for the development of addiction.

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Editor's Notebook
Independent Thinkers

In order to stay competitive in today's economy, independent pharmacies must devise innovative marketing tactics.
Counseling Pearls
Photo Pediatric OCD Associated With Streptococcal Infections

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) manifest as a phenomenon prominently associated with obsessive-compulsive disorder (OCD), tic disorder, or both, in children. There is a clear relationship between infection and neuropsychiatric symptom exacerbation.
Photo Treatment of Depression in Patients on Anticoagulation Therapy: Antidepressant-Warfarin Drug Interactions

The combined use of warfarin and antidepressants, particularly the selective serotonin reuptake inhibitors, may lead to drug-drug interactions via pharmacodynamic and pharmacokinetic mechanisms. Concomitant use of these drugs may exacerbate bleeding risk.
Behavioral Health Management:
Opportunities for Intervention With Health Information Technologies

Health information technology has the potential to impact medication management, care coordination, and management of comorbid conditions in behavioral health.
Clinical Corner
Photo Antipsychotic Use for Behavioral and Psychological Symptoms of Dementia

During the moderate and late stages of the disease, patients experience behavioral and psychological symptoms of dementia (BPSD), such as agitation, psychosis, and aggression. There is no FDA-approved treatment for BPSD, but antipsychotics are frequently prescribed off-label.
Photo Behavioral Side Effects of Antiepileptic Drugs

Most anticonvulsants cause some degree of adverse drug reactions. Behavioral side effects are often overlooked, but are a significant consideration. They include agitation, aggression, psychosis, behavioral disorders, hyperactivity, and restlessness.
Consult Your Pharmacist
Dealing With Poisoning Emergencies

If a child accidentally ingests a toxic substance, it is better to call poison control immediately for advice than to use poison treatment products such as ipecac or activated charcoal.
Educational Spotlight
Drug Rescheduling and Controlled Substances

Federal and state lists of controlled substances and dispensing restrictions continue to evolve.
Pharmacogenomics in Women's Health

Relating genetics to drug response is the basis of this rapidly expanding field.
Screening and Management of Diabetic Kidney Disease

Early recognition and diagnosis of this microvascular complication of diabetes can reduce morbidity and mortality.
New Statin Guidelines Issued
Washington, DC — The American College of Cardiology and the American Heart Association have issued new clinical practice guidelines regarding the treatment of blood cholesterol. The guidelines identify four major groups of patients for whom statins have the greatest chance of preventing stroke and heart attacks, including those with or at a high risk of developing cardiovascular disease, diabetics between 40 and 75 years, and patients with high LDL cholesterol levels. This represents a departure from previous guidelines because it emphasizes the importance of adopting a healthy lifestyle over focusing only on specific cholesterol targets. These recommendations could potentially double the number of patients who are candidates for long-term statin therapy, from 15 to 30 million.
Leukemia Drug Reintroduced as MS Treatment
Silver Spring, MD— An FDA advisory committee has recommended approval of alemtuzumab (Lemtrada) for the treatment of relapsing/remitting multiple sclerosis (MS) despite concerns of design bias in its clinical trials. The drug was sold under the trade name Campath as a treatment for leukemia for many years, but commercial sales were halted once alemtuzumab was acquired by Genzyme so that the company could make the drug available exclusively as an MS treatment. Lemtrada is already approved in Europe, and the FDA is expected to make a final decision later this year.
Pure Hydrocodone Product Approved
Silver Spring, MD— The FDA has approved Zohydro ER (hydrocodone bitartrate extended-release capsules) for the management of pain severe enough to require daily, around-the-clock, long-term treatment and for which alternative treatment options are inadequate. It is classified as a Schedule II drug and is the first FDA-approved single-entity (not combined with acetaminophen, such as in Vicodin) and extended-release hydrocodone product. Despite risks of addiction and abuse, the drug is not being released in a tamper-resistant formula like other available opioids, although it will be monitored as part of the ER/LA Opioid Analgesics Risk Evaluation and Mitigation Strategy (REMS).
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