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July 2010 Briefing - Pharmacy

Here are what the editors at HealthDay consider to be the most important developments in Pharmacy for July 2010. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Flu Vaccine for Upcoming Season Approved

FRIDAY, July 30 (HealthDay News) -- The annual flu vaccine for the 2010-2011 influenza season has been approved by the U.S. Food and Drug Administration, the agency said Friday.

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Transforaminal Steroid Shot Benefits Lumbar Radicular Pain

FRIDAY, July 30 (HealthDay News) -- Transforaminal injection of steroids appears to be a viable alternative to surgery for some patients with lumbar radicular pain caused by disc herniation, according to a study published online July 30 in Pain Medicine.

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FDA: Evamist Tied to Adverse Effects in Children, Pets

FRIDAY, July 30 (HealthDay News) -- The U.S. Food and Drug Administration has warned that unintentional exposure to estradiol transdermal spray (Evamist) through skin contact with patients using the spray may cause adverse effects in children and pets.

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Combination Weight Loss Drugs Appear Effective for Obesity

FRIDAY, July 30 (HealthDay News) -- Treatment with two obesity drugs, naltrexone and bupropion, plus lifestyle modification appears effective in helping people lose 5 percent or more of their excess body weight, according to research published online July 30 in The Lancet.

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Black Youths May Benefit From Higher Vitamin D Dose

FRIDAY, July 30 (HealthDay News) -- Black youths on 2000 IU/day of vitamin D achieve higher vitamin D levels more quickly and have significantly less arterial stiffness than those on 400 IU/day, according to research published online July 21 in the Journal of Clinical Endocrinology and Metabolism.

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Continuous Morphine Plus Injection Preemptive Pain Option

FRIDAY, July 30 (HealthDay News) -- Preemptive analgesia using continuous subcutaneous morphine combined with a single intrathecal injection of morphine (SI) in patients who undergo posterior lumbar interbody fusion provides a favorable analgesic effect and compares favorably with continuous subcutaneous morphine alone (SC), according to a study published in the July issue of the Journal of Spinal Disorders & Techniques.

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Calcium Supplements May Increase Heart Attack Risk

FRIDAY, July 30 (HealthDay News) -- Calcium supplementation is associated with an increased risk of myocardial infarction, according to a meta-analysis published online July 29 in BMJ.

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FDA: Daptomycin May Increase Eosinophilic Pneumonia Risk

FRIDAY, July 30 (HealthDay News) -- The U.S. Food and Drug Administration has requested that the manufacturer of daptomycin (Cubicin) add information to its drug label regarding a possible increased risk of eosinophilic pneumonia in patients receiving the drug.

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Cuvposa Approved for Chronic Drooling in Children

THURSDAY, July 29 (HealthDay News) -- Cuvposa (glycopyrrolate) Oral Solution has been approved by the U.S. Food and Drug Administration to treat chronic drooling in children aged 3 to 16.

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Thiazolidinediones May Up Fracture Risk in Older Women

THURSDAY, July 29 (HealthDay News) -- In type 2 diabetes patients, thiazolidinedione (TZD) exposure is associated with an increased risk of fracture in women age 50 and older -- especially in higher doses -- and in men who are concurrently exposed to loop diuretics, according to research published online July 14 in the Journal of Clinical Endocrinology and Metabolism.

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Sipuleucel-T Linked to Prostate Cancer Survival Benefit

WEDNESDAY, July 28 (HealthDay News) -- Sipuleucel-T -- a therapeutic cancer vaccine -- is associated with prolonged overall survival in men with metastatic castration-resistant prostate cancer, but without a longer time to disease progression, according to research published in the July 29 issue of the New England Journal of Medicine.

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High Doses of UDCA Not Beneficial for NASH Patients

WEDNESDAY, July 28 (HealthDay News) -- High doses of ursodeoxycholic acid (UDCA) do not appear to improve overall histology compared with placebo in patients with nonalcoholic steatohepatitis (NASH), according to a study published in the August issue of Hepatology.

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HIV Care Quality in VA Hospitals Generally High

TUESDAY, July 27 (HealthDay News) -- National performance rates for quality-of-care measures for HIV patients receiving care through the Department of Veterans Affairs (VA) are generally high, though there is variation from facility to facility, according to a study in the July 26 Archives of Internal Medicine. Another study in the same issue suggests that some HIV drugs increase the risk of heart attack in HIV-infected patients.

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Alteplase Remains Safe Up to 4.5 Hours After Acute Stroke

TUESDAY, July 27 (HealthDay News) -- Extending the treatment window for administration of alteplase from three hours to 4.5 hours in patients who experience an acute ischemic stroke is safe and does not result in delayed treatment of patients, according to a study published online July 27 in The Lancet Neurology.

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Some Epilepsy Drugs Linked to Self-Harm, Suicidal Behavior

MONDAY, July 26 (HealthDay News) -- Patients taking newer antiepileptic drugs (AEDs) that are associated with a high risk of depression may have an elevated risk of self-harm or suicidal behavior, but other groups of AEDs do not appear to carry this risk, according to research published in the July 27 issue of Neurology.

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Radiation May Decrease Rate of Gynecomastia in Prostate Cases

MONDAY, July 26 (HealthDay News) -- Prophylactic breast irradiation may decrease the rate of gynecomastia in prostate cancer patients receiving bicalutamide; however, with a relatively low number of men significantly bothered by this issue, not all patients need this prophylaxis, according to research published in the August issue of The Journal of Urology.

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FDA Panels Vote Against Plan to Reduce Opioid Abuse

MONDAY, July 26 (HealthDay News) -- On July 23, two U.S. Food and Drug Administration advisory panels voted against the FDA's plan for reducing abuse of long-acting and extended-release opioid drugs.

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Back Pain Diagnostic Blocks Delay Pain Relief, Add Cost

MONDAY, July 26 (HealthDay News) -- Performing one or more temporary diagnostic nerve blocks to establish arthritis as the cause of back pain before treatment with radiofrequency denervation results in unnecessary tests, delayed pain relief, and added cost, according to a study in the August issue of Anesthesiology.

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Nebivolol Less Effective in Elderly With CHF and Diabetes

FRIDAY, July 23 (HealthDay News) -- In patients aged 70 and older with heart failure, diabetes is associated with a worse prognosis, and nebivolol is less effective in patients with diabetes than in those without it, according to research published in the July 1 issue of the American Journal of Cardiology.

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Stopping Epoetin Regulates High Hemoglobin Levels

FRIDAY, July 23 (HealthDay News) -- In hemodialysis patients, discontinuation of epoetin may be more effective in normalizing elevated hemoglobin levels than reducing the dose of the drug, according to a study published online July 22 in the Clinical Journal of the American Society Nephrology.

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Bevacizumab With Chemo Safe for Non-Squamous NSCLC

THURSDAY, July 22 (HealthDay News) -- Bevacizumab used in combination with standard chemotherapy for advanced non-squamous non-small-cell lung cancer (NSCLC) has a generally manageable safety profile, according to an open-label, single group, phase 4 study published online July 21 in The Lancet: Oncology.

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FDA Panel Advises Against Bevacizumab for Breast Cancer

WEDNESDAY, July 21 (HealthDay News) -- A U.S. Food and Drug Administration advisory panel has recommended that bevacizumab (Avastin) not be used to treat patients with advanced breast cancer, based on lacking evidence of survival benefits.

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Ecstasy May Help Relieve Post-Traumatic Stress Disorder

WEDNESDAY, July 21 (HealthDay News) -- The drug ±3,4-methylenedioxymethamphetamine (MDMA), also known as ecstasy, appears to be effective in treating post-traumatic stress disorder (PTSD) without evidence of harming patients, according to research published online July 19 in the Journal of Psychopharmacology.

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Intervention Ups Vaccination Rate in Health Care Workers

TUESDAY, July 20 (HealthDay News) -- An educational intervention program can increase low influenza vaccination rates in primary health care workers, according to research published in the July/August issue of the Annals of Family Medicine.

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Zinc Nasal Gel May Lead to Loss of Sense of Smell

TUESDAY, July 20 (HealthDay News) -- Use of over-the-counter homeopathic nasal zinc gluconate gel may result in loss of the sense of smell, according to a report in the July issue of the Archives of Otolaryngology -- Head & Neck Surgery.

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Dense Breasts + Hormones Up Cancer Risk After Menopause

MONDAY, July 19 (HealthDay News) -- Postmenopausal women with high breast density, especially those undergoing hormone therapy with estrogen plus progestin, are at higher risk for developing breast cancer, according to a study published online July 19 in the Journal of Clinical Oncology.

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Immunosuppressant Doesn't Improve IgAN Steroid Therapy

MONDAY, July 19 (HealthDay News) -- For patients with IgA nephropathy (IgAN), steroid treatment can prevent or delay loss of kidney function, but the therapy is not improved with the addition of the immunosuppressant drug azathioprine, according to a study published online July 15 in the Journal of the American Society of Nephrology.

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FDA Warns Public Regarding Stolen Advair Diskus Inhalers

MONDAY, July 19 (HealthDay News) -- The U.S. Food and Drug Administration issued a warning to consumers, pharmacists, and wholesalers that certain lots of Advair Diskus (fluticasone propionate and salmeterol inhalation powder) inhalers were stolen from a GlaxoSmithKline distribution warehouse near Richmond, Virginia, in August 2009 and have recently been found in some pharmacies.

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Serial CT Angiography Detects Plaque Morphology Changes

FRIDAY, July 16 (HealthDay News) -- Evaluation of coronary plaques with serial computed tomography angiography (CTA) allows interval changes in plaque morphology to be assessed, and statin treatment is linked to decreases in markers associated with plaque instability, according to a study in the July issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.

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Long-Acting Methylphenidate Falls Short for Cancer Fatigue

FRIDAY, July 16 (HealthDay News) -- Long-acting methylphenidate does not appear to reduce cancer-related fatigue in general, though it may be helpful in patients with more advanced disease or more severe fatigue, according to research published online July 12 in the Journal of Clinical Oncology.

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Admissions for Prescription Pain Reliever Abuse Rising

FRIDAY, July 16 (HealthDay News) -- Substance abuse admissions involving prescription pain reliever abuse increased from 2.2 to 9.8 percent between 1998 and 2008 in those aged 12 and older, according to a recent study by the Substance Abuse and Mental Health Services Administration (SAMHSA).

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18 Months' Treatment Optimal for Q Fever Endocarditis

FRIDAY, July 16 (HealthDay News) -- Q fever endocarditis should be treated with a combination of doxycycline and hydroxychloroquine for a period of 18 months in patients with native values, and through 24 months in patients with prosthetic valves, according to a retrospective study published online July 15 in The Lancet: Infectious Diseases.

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FDA Issues Requirements for Baxter Infusion Pump Recall

THURSDAY, July 15 (HealthDay News) -- The U.S. Food and Drug Administration has issued conditions for Baxter Healthcare Corporation to follow in performing its April 2010 recall of Colleague Volumetric Infusion Pumps (CVIPs), and the agency is requiring the company to provide refunds or replacement pumps for customers or terminate their leases.

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Blister Packs of Coumadin Recalled

THURSDAY, July 15 (HealthDay News) -- Bristol-Myers Squibb has initiated a voluntary recall of physician sample blister packs and hospital unit dose (HUD) blister packs of Coumadin, a medication used to treat or prevent blood clots.

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FDA Panel Recommends Avandia Remain on Market

THURSDAY, July 15 (HealthDay News) -- After two days of deliberations, sparked by concerns over cardiovascular safety issues, a U.S. Food and Drug Administration advisory panel, comprising 33 experts, has recommended that rosiglitazone (Avandia) remain on the market with tightened controls or restricted sales.

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Lorcaserin Linked to Weight Loss, Maintenance

WEDNESDAY, July 14 (HealthDay News) -- The use of lorcaserin, along with behavioral modification, is associated with weight loss and subsequent weight maintenance compared to placebo, according to a study published in the July 15 issue of the New England Journal of Medicine.

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Benefits Seen With Early Antiretroviral Therapy in HIV

WEDNESDAY, July 14 (HealthDay News) -- Early initiation of antiretroviral therapy in HIV-infected adults with CD4+ T-cell counts below 350 per cubic millimeter may lower the rates of death and new cases of tuberculosis, according to research published in the July 15 issue of the New England Journal of Medicine.

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Studies Assess Rituximab in ANCA-Associated Vasculitis

WEDNESDAY, July 14 (HealthDay News) -- In patients with severe antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, a rituximab-based regimen and standard intravenous cyclophosphamide may both lead to high sustained-remission rates, and rituximab may be superior for relapsing disease, according to two studies published in the July 15 issue of the New England Journal of Medicine.

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Home, Hospital Antibiotics Offer Similar Results in Cystic Fibrosis

WEDNESDAY, July 14 (HealthDay News) -- Cystic fibrosis (CF) patients treated with intravenous antibiotics for respiratory exacerbations have similar lung function outcomes whether their therapy is administered at home or in the hospital, according to research published online June 25 in the American Journal of Respiratory and Critical Care Medicine.

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FDA: Antirheumatic Drug Gets New Boxed Warning

WEDNESDAY, July 14 (HealthDay News) -- The U.S. Food and Drug Administration has added information on risk of severe liver injury to the boxed warning of leflunomide (Arava), a disease-modifying antirheumatic drug.

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ASCO Guidelines Recommend Aromatase Inhibitor Use

TUESDAY, July 13 (HealthDay News) -- An aromatase inhibitor (AI) should be included in adjuvant endocrine therapy for postmenopausal women with hormone receptor-positive breast cancer, according to updated American Society of Clinical Oncology guidelines published online July 12 in the Journal of Clinical Oncology.

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Infant Heart Defects Linked to Pregnancy Bupropion Use

MONDAY, July 12 (HealthDay News) -- Maternal use of bupropion during early pregnancy appears to have a modest positive association with left outflow tract heart defects in infants, according to a study published in the July issue of the American Journal of Obstetrics & Gynecology.

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Gastric Acid Drugs May Increase Hip Fracture Risk

FRIDAY, July 9 (HealthDay News) -- The use of drugs that inhibit gastric acid is linked to a higher risk of hip fracture among patients; however, with proton pump inhibitors (PPIs) this appears limited to those who have at least one other fracture risk factor, according to research published in the July issue of Gastroenterology.

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FDA: Off-Label Use of Malaria Drug Tied to Serious Effects

FRIDAY, July 9 (HealthDay News) -- In response to continued reports of serious side effects in patients using quinine sulfate (Qualaquin) off-label for the treatment or prevention of nocturnal leg cramps, the U.S. Food and Drug Administration has approved a Risk Evaluation and Mitigation Strategy (REMS) to educate practitioners and patients about the potential for serious side effects associated with such unapproved uses.

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Risk of GI Bleeding Varies by NSAID Type, Dosage

WEDNESDAY, June 2 (HealthDay News) -- The risk of gastrointestinal (GI) complications due to nonsteroidal anti-inflammatory drug (NSAID) use varies by the specific drug used and by dosage, and those with a slow-release formulation or long half-life are associated with a greater risk, according to research published in the June issue of Arthritis & Rheumatism.

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Telemonitoring, Self-Titration Tied to Lower Blood Pressure

THURSDAY, July 8 (HealthDay News) -- Patients who self-manage their antihypertensive medication and engage in telemonitoring of their blood pressure (BP) measurements appear to fare better than patients who receive conventional treatment for hypertension, according to a study published online July 8 in The Lancet.

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Nutraceutical Drug Use Often Ignored by Clinicians

WEDNESDAY, July 7 (HealthDay News) -- Although the use of nutraceuticals and nonprescription over-the-counter (OTC) drugs may be high among patients, cardiovascular clinicians may largely ignore the use of these agents among their patients, according to research published in the July 6 issue of the Annals of Internal Medicine.

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Olaparib Shows Benefit in Cancer With BRCA Mutations

WEDNESDAY, July 7 (HealthDay News) -- Olaparib may be useful in treating women with BRCA1 or BRCA2 mutations who have advanced breast or ovarian cancer, according to the results of two studies published online July 6 in The Lancet.

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Glucosamine Similar to Placebo in Treating Back Pain

TUESDAY, July 6 (HealthDay News) -- Compared with placebo, treatment with glucosamine is not associated with reductions in pain-related disability in people with chronic low back pain and degenerative lumbar osteoarthritis, according to a study in the July 7 issue of the Journal of the American Medical Association.

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Cardiac, Pulmonary Function of Ticagrelor Patients Studied

TUESDAY, July 6 (HealthDay News) -- Dyspnea is commonly reported by coronary artery disease (CAD) patients taking ticagrelor, but it does not appear to have a negative impact on cardiac or pulmonary function in these patients, according to research published in the July 13 issue of the Journal of the American College of Cardiology.

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Users of ED Drugs Have Higher Rates of Sexual Diseases

TUESDAY, July 6 (HealthDay News) -- Men using medication for erectile dysfunction (ED) have higher rates of sexually transmitted diseases (STDs) -- especially HIV infection -- both before and after using these drugs, according to research published in the July 6 issue of the Annals of Internal Medicine.

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TMP-SMX Associated With Hyperkalemia in Elderly

FRIDAY, July 2 (HealthDay News) -- Older patients taking trimethoprim-sulfamethoxazole (TMP-SMX) have a substantially increased risk of hyperkalemia requiring hospitalization, but being on β-blockers does not further increase this risk, according to research published online July 1 in the Clinical Journal of the American Society of Nephrology.

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Type 2 Diabetes Diagnosis May Temporarily Up Depression Risk

FRIDAY, July 2 (HealthDay News) -- Although awareness of a type 2 diabetes diagnosis may temporarily increase the risk of depressive symptoms, it is unlikely that awareness of the diagnosis will have a lasting effect on depression risk, according to research published in the July issue of Diabetes Care.

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Report Addresses Physician Financial Conflicts in Care

THURSDAY, July 1 (HealthDay News) -- In a new report, the Association of American Medical Colleges (AAMC) urges U.S. teaching hospitals to establish policies that ensure financial relationships between physicians and industry do not result in conflicts of interest that influence patient care.

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Switching Prostate Meds Can Drive Up PSA Velocity

THURSDAY, July 1 (HealthDay News) -- In patients with benign prostatic hyperplasia (BPH), switching from one 5α-reductase inhibitor to another can result in a significant change in prostate-specific antigen (PSA) velocity that may prompt physicians to order unnecessary biopsies, according to research published in the July issue of The Journal of Urology.

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