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News Facts Supporting the Development or Expansion
of Pharmacy Programs
Pharmacist Shortage:
A nationwide survey conducted by
NACDS showed that there were 5,971 vacancies in retail pharmacist
positions in July 2005. This is an increase from January 2004 when
there were 4,008 vacancies.
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Health Policy
Medicare part D Comprehensive Update for All
Health Care Providers
February 8, 2006
Crown Plaza Hotel, Warwick
The Rhode Island Pharmacists Association
held a meeting focusing on updates pertaining to Medicare Part D.
Kimberly McDonough, PharmD, BCBPS, President, CEO of Advanced Pharmacy
Concepts detailed the Medicare Modernization Act and explains components
this act includes besides prescription benefits. A Progress Report on
Medicare Part D was presented by Adele Pietrantoni, RPh, Pharmacist,
Boston Regional Office Centers for Medicare and Medicaid Services. John
Young, CPM, the Associate Director of Health Care Quality, Financing and
Purchasing from the RI Department of Human Services spoke about the
impact of Part D on the state Medicaid program. Listed are a summary of
major points from the meeting.
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Therapeutics
Proposed: HIV Post Exposure Prophylaxis
Guidelines and Emergency Kit Inclusions
I. Definition of
Exposure: The exchange of blood and/or body fluids between an
HIV (Human Immunodefiency Virus), infected individual and a non-HIV
infected individual. Exposure may be caused by needle sticks of infected
needles, sexual contact, or exposure to open sores/cuts on infected
individuals.
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Medication Overview: Subutex (Buprenorphine) and
Suboxone (Buprenorphine/Naloxone)
Background:
Opioid addiction in the United States affects up to one
million people at a time and costs the United States more than $20
billion per year. (1) Opioids have been used for thousands of years,
and terminating the use of these substances is often extremely
difficult. Failure to remain opiate free is difficult and may be caused
by long-term depression, lack of energy, drug cravings, and sudden
attacks of physical withdrawal sickness. For some, these symptoms
diminish over time and eventually disappear altogether. However, others
continue to suffer indefinitely with many eventually relapsing to
regular use of opioids. For more than 30 years, methadone has been used
to treat opioid addiction. Methadone occupies the opioid mu receptor in
the brain and is the stabilizing factor that permits addicts on
methadone to change their behavior and to discontinue opioid use by
reducing drug cravings. However,
in October 2002, the FDA approved the buprenorphine
monotherapy product, Subutex, and a buprenorphine/naloxone combination
product, Suboxone, for use in opioid addiction treatment. (2,3)
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article
Prostate Cancer Overview
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article
TOBI vs. Inhaled IV Tobramycin
Prior to the
introduction of TOBI® (tobramycin solution for inhalation), the
intravenous (IV) formulation of tobramycin (Nebcin®) was administered
via a nebulizer, for the management of cystic fibrosis (CF) patients
with Pseudomonas aeruginosa lung infections1. TOBI® was patented in
1996 and FDA-approved in November 1997 for the treatment of pseudomonal
lung infections in people with CF. TOBI® is a ready-to-use ampule for
nebulization that contains 300 mg of tobramycin in 5 mL with no
preservatives. Injectable tobramycin is available as 80mg/2 mL vials
and must be diluted with 2 mL of saline solution before administration
via a nebulizer (henceforth, “nebulized tobramycin”). Nebulized
tobramycin contains phenol and metabislfites as preservatives. TOBI®
300 mg is administered twice daily, whereas nebulized tobramycin has
been dosed up to 600mg three times a day. However, nebulized tobramycin
is often given at similar doses to TOBI®2,3. Both TOBI® and nebulized
tobramycin improve pulmonary function, decrease the density of P.
aeruginosa in sputum, and decrease the risk of hospitalization4,5. Two
areas of debate surround the use of nebulized tobramycin and TOBI®: 1)
concern about the adverse effect profile of each product, specifically
bronchoconstriction and 2) the cost difference between the products.
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