Pharmacy & Therapeutics- July 2008 - (Page 425) Pain Management and Medication Errors 12. Kaiko RF, Foley KM, Grabinski PY, et al. Central nervous system excitatory effects of meperidine in cancer patients. Ann Neurol 1983;13:180–185. 13. Pletcher, M, Kertesz, S, Kohn, M, Gonzalez, R. Trends in opioid prescribing by race/ethnicitiy for patients seeking care in U.S. emergency departments. JAMA 2008;299(1):70–78. 14. Frasco PF, Sprung J, Trentman TL. The impact of the Joint Commission for Accreditation of Healthcare Organizations pain initiative on perioperative opiate consumption and recovery room length of stay. Anesth Analg 2005;100:162–168. 15. Office of National Drug Control Policy, Executive Office of the President of the United States. Teens and prescription drugs: An analysis of recent trends on the emerging drug threat. February 2007. Available at: www.mediacampaign.org/teens/brochure.pdf. Accessed March 30, 2008. 16. 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Crit Care Med 1999;12:2844–2846. 27. Fu ES, Downs JB, Schweiger JW, et al. Supplemental oxygen impairs detection of hypoventilation by pulse oximetry. Chest 2004;126(5):1552–1558. 28. Patanwala AE. Opioid conversions in acute care. Ann Pharmacother 2007;41(2):255–266. 29. Merskey H, Bogduk N, eds. Classification of Chronic Pain, 2nd ed. Seattle: International Association for the Study of Pain (IASP) Press; 1994. 30. Fordyce WE. Behavioural Methods for Chronic Pain and Illness. St. Louis: CV Mosby; 1976. 31. Wolff BB. Ethnocultural factors influencing pain and illness behavior. Clin J Pain 1985;1:23–130. 32. Melzack R, Wall PD. Pain mechanisms: A new theory. Science 1965;50:971–979. 33. Soto RG, Fu ES, Vila H, Miguel RV. Capnography accurately detects apnea during monitored anesthesia care. Anesth Analg 2004;99:379–382. I MEETING HIGHLIGHTS: ASCO continued from page 403 secondary endpoints. Reporting on the results, Dr. O’Day said that best overall response rate was 5.8% (for 9 of 155 patients), and the disease control rate (best response of complete plus partial responses plus stable disease) was 27.1% (in 42 of 155 patients). Despite the modest best overall response rate, median overall survival was 10.22 months and the one-year survival rate was 46.67%. These findings were “remarkably consistent” with those from two other ipilimumab trials in this population (by Dr. Hamid and Dr. Weber), which, together with Dr. O’Day’s study, included nearly 500 patients. Dr. O’Day emphasized that best overall response did not accurately capture ipilimumab’s activity. Because with immunotherapy “you have to build up your army” (which takes 12 to 24 weeks), he said that survival is the more important endpoint and that early progression does not preclude a subsequent response. Also, even though survival time has typically been six to nine months with high-dose interleukin 2 (IL-2), with ipilimumab there is a plateau effect for about 30% of patients, with survival ranging from 10 to 15 months. Grade 3 and 4 immune-related adverse events were reported in 21.9% of patients, with gastrointestinal effects the most common (8.4%). Long-term survival correlated highly with these immune overactivation side effects. Dr. O’Day commented further that IL-2 is given in hospitals or often in the intensivecare unit because of acute side effects—which do not cor relate with better outcomes. REFERENCE 1. Kantarjian H, O’Brien S, Talpaz M, et al. Outcome of patients with Philadelphia chromosome–positive chronic myelogenous leukemia post-imatinib mesylate failure. Cancer 2007;109:1556– 1560. I COMING SOON TO P&T EDITORIAL: The Four-Way Win David B. Nash, MD, MBA DRUG FORECAST: Combating Non-nucleoside Reverse-Transcriptase Inhibitor Resistance: A Focus on Etravirine (Intelence) Nathaniel Eraikhuemen, PharmD, Angela M. Thornton, PharmD, Evans Branch III, PharmD FEATURE ARTICLE: Monitoring Asthma Control Using Claims Data And Patient-Reported Outcomes Measures Tom James, MD, and Michael Fine, MD CONTINUING EDUCATION CREDIT: The Pharmacological Management of Migraine, Part 2: Preventative Therapy George DeMaagd, PharmD, BCPS Vol. 33 No. 7 • July 2008 • P&T® 425 http://www.mediacampaign.org/teens/brochure.pdf http://www.casacolumbia.org/absoluten/articlefiles/380-under_the_counter_diversion.pdf http://www.casacolumbia.org/absoluten/articlefiles/380-under_the_counter_diversion.pdf http://www.casacolumbia.org/absoluten/articlefiles/380-under_the_counter_diversion.pdf
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