Sunday, June 21, 2009

Home Infusion Therapy Overview Part 1

Home Infusion Therapy has been a well defined part of the U.S's integrated medical system since the late 70's/early 80's due to new technological advances and the need to reduce health care expenditures. Patients who receive this service often have better medical outcomes, improved patient & family quality of life, reduced risk of nosocomial (hospital acquired) infections and significantly reduced medical expenses. Pharmacists and nurses play a major role in making this service a success while providing critical feedback/support to the physician, patient and patient's family.

Wednesday, June 17, 2009

Plavix Interaction with Proton Pump Inhibitors

There are new warnings concerning the concomitant use of Proton Pump Inhibitors (PPI's) (especially Prilosec and Nexium which are commonly used to prevent acid reflux or peptic ulcer disease) with a popular antiplatelet drug called "Plavix". Plavix which is used to prevent thrombotic stroke and transient ischemic attacks (TIA's) has been shown to have significantly reduced antiplatelet activity when used in combination with PPI's, thus increasing the inherent risks of developing stroke or TIA's. So far, this interaction seems to be more apparent with Prilosec (Omeprazole) and Nexium (esemeprazole). Protonix (pantoprazole) seems to be the least likely to cause this interact. Thus, doctors are now considering switching their patients to either Protonix or other classes of drugs that reduce gastric acid like H-2 blockers (not cimetidine) to prevent this possibly significant interaction.

My opinion regarding PPI's in general is stop their use altogether....if medically possible. They have been shown to increase the risk of fractures and increase the risk of pneumonia. Remember, we need acid to absorb calcium and gastric acid is also a natural barrier to invading organisms. Don't stop PPI's abruptly......they must be tapered over time (usually over a couple of weeks) to prevent a rebound effect (rapid increase of acid in your stomach). Remember, PPI's only serve to act as temporary band-aid for your real gastrointestinal issue(s).

Did you know that Talc can cause cancer ?

For the last 30 years, scientists have closely scrutinized talc particles and found dangerous similarities to asbestos (a known carcinogen). Talc particles have been shown to cause tumors in the ovaries and lungs of cancer victims. Responding to this evidence in 1973, the FDA drafted a resolution that would limit the amount of asbestos-like fibers in cosmetic grade talc. However, no ruling has ever been made and today, cosmetic grade talc remains non-regulated by the federal government. Note: In a recent study from Harvard University involving 3000 women, daily application of talc to the genital area showed a 41% increase in ovarian cancer rates. Even weekly application showed increased rates of ovarian cancer as high as 36%.

Next time you purchase a body powder make sure it is talc-free. Read the label carefully.

How is a "Brown Bag" Relevant to Pharmacy ?

In 1982, a form of medication review commonly recognized as the "Brown Bag" method became common practice in the United States. In the original project, the method of medication review actually involved patients bringing their medications to a pharmacist in a brown paper supermarket bag for subsequent review.