Pharmacy and Therapeutics - January 2008 - (Page 6) CONTENTS Cover: Color angiogram of the coronary arteries (orange) in a patient with heart disease. Stenosis of the blood vessels (left) usually results from atherosclerosis. See related article on page 51. (Credit: Zephyr / Photo Researchers, Inc.) January 2008 FEATURES Impact of Bipolar Disorder on the Family: Utilization and Cost of Health Care Resources The authors describe a study in which “bipolar families,” compared with families without a serious mental illness, incurred much higher medical costs, visited physicians more often, had more hospital stays, and spent more money on prescription drugs. Mary Lou Chatterton, PharmD, Xiongkan Ke, MS, Barbara Edelman Lewis, PhD, MHA, Krithika Rajagopalan, PhD, and Arthur Lazarus, MD, MBA CASE REPORT 15 DEPARTMENTS Editorial 7 David Nash, MD, MBA, reviews Better: A Surgeon’s Notes on Performance, a book in which Dr. Atul Gawande asserts that our health care system won’t improve until we rethink our everyday practices. Medication Errors 8 In Part 2 of a two-part series, Matthew Grissinger, RPh, FASCP, details the steps needed for safely prescribing and dispensing patient-controlled analgesia (PCA). Prescription: Washington 10 Stephen Barlas discusses how consumers might have access to a number of “behind-thecounter” drugs only after they are counseled by a pharmacist. New Drugs/Drug News/ New Medical Devices 11 From cephipeme to valsartan, P&T presents the latest information about FDA approvals, new indications, recalls, and industry updates. Drug Forecast 42 Drs. Colabella and Chagan review dalbavancin (Zeven), a glycopeptide for resistant gram-positive organisms. Aripiprazole (Abilify) and Tardive Dyskinesia Second-generation atypical antipsychotic drugs carry a lower risk of extrapyramidal symptoms and tardive dyskinesia compared with conventional agents, but they are not without their dangers. The case report of a 46-year-old patient demonstrates the point that the newer agents should be used according to their FDA-approved indications, when possible, and that patients using aripiprazole, an “atypical atypical” agent, need to be carefully monitored. Thomas Schwartz, MD, and Shafi Raza, MD 32 Advances in Vaccine Technology and Their Impact On Managed Care Although the “vaccine revolution” has resulted in products that can prevent illness and reduce costs of disease, the authors raise several concerns: who will pay for these improvements, how these advances will alter treatment, how cost and efficacy will be balanced, and how to choose the right product. Jonathan A. McCullers, MD, and Jeffrey D. Dunn, PharmD, MBA MEETING HIGHLIGHTS 35 American Heart Association, 2007 Scientific Sessions Presentations cover a number of clinical trials of cardiac agents, including clopidogrel versus prasugrel; an investigative thrombin receptor antagonist; a niacin/simvastatin combination; warfarin dosing versus genotype-guided dosing; clopidogrel eptifibatide, and bivalirudin; and eptifibatide versus abciximab. Walter Alexander 51 Pharmaceutical Approval Update Topics include nilotinib (Tasigna Capsules) for the treatment of chronic myelogenous leukemia (CML), raltegravir (Isentress) for patients with HIV-1 infection, and ixabepilone (Ixempra), combined with capecitabine (Xeloda), for use in metastatic or locally advanced breast cancer. Marvin M. Goldenberg, PhD, RPh, MS 54 6 P&T® • January 2008 • Vol. 33 No. 1
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