Drug Topics - April 14, 2008 - (Page 29)

APRIL 14, 2008 DRUG TOPICS 29 Cover Story adults, but only orlistat (Xenical, Roche) is approved for use in overweight adolescents 12-16 years of age. Orlistat contributes to weight loss by blocking absorption of dietary fats in the gastrointestinal tract. Unabsorbed fat is eliminated with bowel movements and may cause stools to be soft, oily, orange, and more frequent. Abdominal discomfort and flatulence are also common side effects. Maximal weight loss may occur in as little as 12 weeks of treatment. One drawback to orlistat, however, is that the drug not only prevents absorption of dietary fat, but also fat-soluble vitamins. As a result, some pharmacists recommend DT CAPSULE that adolescents using orlistat take a multivitamin containing vitamin A (5000 IU), vitamin D (400 IU), vitamin E (300 IU), and vitamin K (25 ug) each day. Additionally, youngsters using orlistat should be counseled to separate their vitamins from the weight-loss agent by at least two hours to ensure complete absorption of the vitamins. Young people using orlistat should also have regular visits to their healthcare provider to have height and weight checks performed, as well as serum vitamin levels assessed periodically. Although orlistat recently became available without a prescription (Alli, GlaxoSmithKline Consumer Healthcare), this lower strength dosage form should not be used by individuals under 18 years of age because periodic monitoring by a physician is recommended for adolescents taking orlistat. Children cannot be considered “little adults” in their response to medications. What can pharmacists do? “Pharmacists can play a significant role in helping to curb the trend of increased medication use,” believes Cox, “by actively recommending non-drug preventative measures and monitoring children that may be on medications commonly used by adults.” Additionally, Cox reminded pharmacists to stay alert for medications that require dosing adjustments and have different side-effect profiles for children. Pharmacists can also help patients by calculating their body mass index (BMI), estimating an appropriate daily caloric intake, and suggesting healthy ways to cut calories and lose excess weight. Ultimately, lifestyle changes and behavior modifications should be attempted before medication therapy is used in obese children. Psychological conditions Treating psychiatric conditions in children is especially challenging. Few psychotropic medications have indications for children, so there are sparse clinical data on which physicians can rely. Furthermore, children often present with different symptoms than do adults with the same diagnosis. Parental barriers also pose challenges in treating certain psychiatric conditions, especially the highly prevalent attention deficit

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Drug Topics - March 14, 2008 Contents Latebreakers Letters: Students Need Grounding in Chemistry Pharmacy Directors Wary of Heparin Shortages Some E-prescribing Standards are Ready to Go, Others are Not News Briefs Nanotechnology: Big Stakes in a Small World Pay for Performance is Coming to Pharmacy Patient Safety Organizations Still Very Much in Planning Stage Reconciling Medications in Specialty Patients Poses More Challenges Pharmacy Outsourcing Still Much in Use by Hospitals Studied Extensively, New Drug-Eluting Stent Said to be Very Safe Prevention is Key in Treating C. Difficile Infections E-prescribing Grows in Massachusetts, but Other States Lag Behind Active Metabolite Gives New Life to Antidepressant NSAIDS not Recommended for Long-term Use in Osteoarthritis This Time R.Ph.s and States Are Ready for Tamper-Resistant Rx Pads Cardinal Caught Between DEA and Pharmacies over Diversion Control Medicating Kids: Still More Questions than Answers Schnucks Pharmacy: Drug Topics' Chain of the Year Panel Will Ask for a System for R.Ph. Practice Across State Lines FDA Safety Page: How to use Fentora Safely The Shining OTC/HBC Stars of 2007 Take a Look at These OTCs for Eye Health Technology Update: Google Offers a Sneak Peak at its Electronic Records Initiative Recent Advancements in HIV/AIDS Treatment New Products Advertisers Index Classified Viewpoint: Are State Boards of Pharmacy Abusing Their Power?

Drug Topics - April 14, 2008

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