RESUMEN

Reputable medication safety resources are fundamental to assist in reducing medication errors and educating consumers. The purpose of this article is to describe medication safety and pharmacovigilance electronic and mobile resources that are available to pharmacists to enhance patient safety in the ambulatory care setting at the national level through the US Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), American Medicine Chest Challenge, and Institute for Safe Medication Practices (ISMP). Information concerning drug disposal methods is available through the FDA, DEA, and the American Medicine Chest Challenge Rx Drop app. The ISMP provides a variety of tools for reporting and preventing medication errors including Assess-ERR and ConsumerMedSafety.org. Risk Evaluation and Mitigation Strategies (REMS) were created as a requirement of the FDA Amendments Act of 2007 to ensure that the drug's benefits outweigh the risks. Health care professionals are encouraged to report adverse drug events through the FDA's MedWatch reporting system. Pharmacists have a variety of useful resources for their medication safety and pharmacovigilance toolbox. Studies should evaluate the use of these resources by pharmacists and consumers.

RESUMEN

OBJECTIVE: The purpose of this study is to assess Florida physicians' attitudes and knowledge toward accessing the state's prescription drug monitoring program (PDMP). DESIGN: Five thousand medical doctors and osteopathic physicians licensed in Florida were randomly selected for a voluntary and anonymous 15-question self-administered survey approved by the Institutional Review Board. Surveys were distributed through U.S. postal service mail. Likert-scale questions were used to assess prior knowledge (1 = none to 5 = excellent) and attitudes toward accessing the PDMP (1 = strongly disagree to 5 = strongly agree). RESULTS: The study yielded a response rate of 7.8%, 71.5% of whom agreed or strongly agreed that the PDMP is a useful tool. Among participants that have access and answered the PDMP usefulness question, 94.8% agree or strongly agree that it is a useful tool. There were 63 out of 64 physicians (98.4%) who conducted 25 or more searches who agreed or strongly agreed that the PDMP is a useful tool for monitoring patients' controlled substance histories. There were 72.5% of participants with access that answered the "doctor shopping" question who agreed that "doctor shopping" will decrease. Among the 64 most frequent PDMP users, 69.4% agreed or strongly agreed that they have prescribed fewer controlled substances after accessing the PDMP. CONCLUSIONS: The study revealed that a majority of participants believe that the PDMP is a useful tool for monitoring patients' controlled substance histories. More continuing education programs should be provided to Florida physicians to enhance their knowledge regarding PDMPs.

Asunto(s)

RESUMEN

INTRODUCTION: Use of dipeptidyl peptidase-4 (DPP-4) inhibitors is prevalent for the treatment of type 2 diabetes since they have fewer adverse effects compared with other non-insulin medications currently available; however, as monotherapy, the glycosylated hemoglobin (HbA1c)-lowering power of these agents is moderate. The aim of this article is to evaluate the current literature regarding the safety and efficacy of DPP-4 inhibitors in combination with metformin. METHODS: A literature search was conducted through MEDLINE (from 1950 to October 2012), PubMed (from 1966 to October 2012), EMBASE (from 1966 to October 2012), and International Pharmaceutical Abstracts (from 1970 to October 2012) using the search terms "sitagliptin," "linagliptin," "alogliptin," "vildagliptin," "saxagliptin," and "metformin." Studies that did not evaluate the DPP-4 inhibitors in combination with metformin and those that were not phase 3, were excluded. RESULTS: Many of the studies evaluated DPP-4 inhibitors in combination with metformin versus glucagon-like peptide-1 (GLP-1) agonists, placebo, DPP-4 inhibitors as monotherapy, thiazolidinediones, and sulfonylureas. The results of these noninferiority trials were that DPP-4 inhibitors as a whole are noninferior to either each other or other agents except for GLP-1 agonists. Also, in superiority studies, GLP-1 agonists proved to have greater HbA1c lowering. CONCLUSION: In summary, DPP-4 inhibitors play a vital role in the treatment of diabetes. They have relatively limited adverse effects, especially regarding hypoglycemia. DPP-4 inhibitors in combination with metformin are generally well tolerated and are available as combination products to reduce pill burden and enhance compliance. The limitations to DPP-4 inhibitors are the lack of outcomes data and more limited HbA1c lowering than other medications currently approved for the treatment of type 2 diabetes. However, as previously stated, thiazolidinediones, glinides, sulfonylureas, pramlinitide, and GLP-1 agonists are all quite beneficial in HbA1c lowering but are not without major adverse effects. Therefore, DPP-4 inhibitors have a vital role as an oral add-on agent for the treatment of type 2 diabetes.

Asunto(s)

RESUMEN

The growing abuse of toxic stimulants known as "bath salts" can cause psychosis and possibly death. Raising awareness of the dangers through patient counseling and community outreach programs will be important-especially efforts aimed at young people.

RESUMEN

A controversial bill to change the classification of the opioid hydrocodone from Schedule II to Schedule II might help decrease the incidence of drug abuse through stricter regulation of Schedule II products, or, as some groups claim, it might hinder access for patients with legitimate prescriptions.

RESUMEN

OBJECTIVE: To review the current legal status and patterns of abuse of bath salts. DATA SOURCES: A literature search was conducted through MEDLINE (1950-December 2011), PubMed (1966-December 2011), EMBASE (1966-December 2011), and International Pharmaceutical Abstracts (1970-December 2011) using the search terms bath salts, mephedrone, and methylenedioxypyrovalerone to identify articles on the legal status of bath salts and on studies focusing on patterns of abuse of bath salts. The GovTrack.us Web site was searched to determine the status of federal bills regarding bath salts. The National Association of Boards of Pharmacy and Drug Enforcement Administration Web sites and the Federal Register were also examined to identify legislation on bath salts. STUDY SELECTION AND DATA EXTRACTION: Case reports and studies regarding bath salts were examined. Federal laws involving bath salts were also evaluated. DATA SYNTHESIS: The Department of Justice issued a final order in the Federal Register, temporarily placing the 3 synthetic stimulants, mephedrone, methylenedioxypyrovalerone, and methylone, under Schedule I of the Controlled Substances Act. Literature evaluated included case reports, retrospective studies, surveys, toxicology data, and chemical analyses studies. Information in the literature demonstrated that bath salts are highly abused, and common adverse effects include hypertension, tachycardia, and psychiatric symptoms. CONCLUSIONS: Psychoactive substances recently sold as bath salts have been placed in Schedule I of the Controlled Substances Act. Pharmacists can play an important role in raising awareness on the dangers of bath salts abuse through patient counseling and community outreach programs. The evidence on legal status and patterns of abuse clearly demonstrates that bath salts contain dangerous substances that should be permanently controlled.

Asunto(s)