Pharmacy & Therapeutics - February 2008 - (Page 86)

NEW DRUGS agitation. This agent is also contra indicated in children who have taken a monoamine oxidase inhibitor within the previous 14 days. (Sources: Shire, January 3, 2008; www. vyvanse.com.) DRUG NEWS Prescribing rates were particularly low for African-American and Hispanic children, African-Americans in county and state hospitals, Asians and Medicare patients, and non-white patients living in the northeastern states. The study was not designed to determine the causes of these ethnic disparities. The authors called for ongoing education about pain for physicians and nurses and promotion of cultural awareness. (Source: JAMA, January 2, 2008.) Once-Daily Tadalafil (Cialis) Eli Lilly has received the FDA’s approval to offer its erectile-dysfunction drug, tadalafil (Cialis), in once-daily dosages of 2.5 mg and 5 mg. This approval was based on results from three phase 3 randomized, double-blind, placebo-controlled studies. Tadalafil in strengths of 5 mg, 10 mg, and 20 mg has been indicated for asneeded treatment since November 2003 in the U.S. It is the only drug for erectile dysfunction that is approved as a daily treatment regimen. The wholesale price of the new dose will be comparable to the cost of taking two pills of the original formulation. (Sources: Associated Press, January 9, 2008; Reuters, January 8, 2008; www. healthcentral.com.) every minute lost, the chances of survival worsen. With a six-minute delay or more, the chances of remaining alive are only 25%, compared with immediate treatment. Patients who did not receive quick electric jolts died at nearly twice the rate of those who were treated promptly. Late responses were seen most often for African-American patients, in hospitals with fewer than 250 beds, in hospital units not being monitored, at night, and on weekends. The data did not explain why African-Americans had longer waits. Of the 370,000 to 750,000 patients who experience cardiac arrest and who need resuscitation each year, only 30% survive long enough to go home. (Sources: N Engl J Med 2008;358:9–17; USA Today, January 2, 2008.) Longer Waits For All Patients In Emergency Rooms Waits for emergency care are getting longer each year for most patients. Researchers from the Cambridge Health Alliance and Harvard Medical School analyzed the time between arrival in the ED and when patients were first seen by a doctor. More than 90,000 ED visits nationwide were evaluated between 1997 and 2004. Increasing delays affected all racial and ethnic groups; even patients with health insurance and critically ill patients waited longer for treatment. Severely ill patients experienced the largest increase in waits. During the study, wait times increased by 36% for all patients (from 22 to 30 minutes), and for those needing immediate attention, wait times increased by 40% (from 10 to 14 minutes). Most patients experiencing hear t attacks also waited: 8 minutes in 1997 but 20 minutes in 2004 (a 150% increase). In 2004, 25% of hear t attack victims waited 50 minutes or more before they could see a doctor. Waits were slightly longer for AfricanAmerican and Hispanic patients as well as women. Patients at rural hospitals had the shortest waits. The number of ED visits increased Minorities Receive Less Pain Relief African-American and Hispanic patients remain less likely than white patients to receive pain relievers in emergency departments (EDs), according to a study from the University of California, San Francisco. Researchers analyzed nearly 375,000 ED visits over 13 years. About 42% of these visits were for pain. Between 1993 and 2005 at U.S. hospitals, 31% of whites received opioid drugs, compared with only 23% of African-Americans, 24% of Hispanics, and 28% of patients of Asian ancestry. In contrast, non-opioid pain relievers, such as acetaminophen and ibuprofen, were prescribed more often to non-whites (36%) than to whites (26%). African-Americans received opioids less often than other groups for almost every type of pain-related ED visit, and differences in prescribing were greatest for people with the worst pain. About 52% of whites in severe pain received opioids, compared with only 42% of Hispanics and 39% of African-Americans. DRUG NEWS Disparities in Treatment Survival Decreases With Delayed Defibrillation About one-third of patients experiencing cardiac arrest in hospitals are not getting a defibrillator within the recommended two minutes. In a new study, 6,789 patients had heart attacks resulting from ventricular fibrillation in 369 hospitals. Overall, the hospital staff took an average of one minute to apply the paddles, but in nearly one-third of the cases, it took longer than the recommended two minutes. Cardiac arrest occurs when the heart’s electrical system misfires. Patient survival is increased if defibrillator paddles are used to shock the patient’s heart back to life within two minutes, but for 86 P&T® • February 2008 • Vol. 33 No. 2 http://www.vyvanse.com http://www.vyvanse.com http://www.healthcentral.com http://www.healthcentral.com

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Pharmacy & Therapeutics - February 2008 Contents Editorial Medication Errors Prescription: Washington The Language of (Forgive Us) Change, As P&T Enters the Digital Age New Drugs/Drug News/New Medical Devices Drug Forecast Use and Outcomes of Antifibrinolytic Therapy in Patients Undergoing Cardiothoracic Surgery at 20 Academic Medical Centers in the United States Evaluation of the Management of Acute Venous Thromboembolism and Its Outcomes: One Institution's Experience American Society of Hematology, 49th Annual Meeting Pharmaceutical Approval Update

Pharmacy & Therapeutics - February 2008

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