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Pharmacist MedPulse®

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MedPulse is a weekly index of key news and features on Medscape's specialty sites compiled by Medscape's Editors.

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ALSO IN THIS ISSUE:NEWSMEMBER NEWSUSER SUPPORT

NEW FEATURES THIS WEEK

Improving Clinical Outcomes Over the Continuum of a Patient's Care

Researchers need to ask whether cost-containment practices impact quality of care and overall utilization of medical resources.Drug Benefit Trends 15(10) 2003

How Nurse Practitioners Obtained Provider Status: Lessons for Pharmacists

Pharmacy practice has evolved into a comprehensive set of clinical, consultative, and educational services.Am J Health-Syst Pharm 60(22) 2003

Neuroethics: How To Leave the Cave Without Going Astray

"I am much more than my genes, they are not my essence, they are not my soul; is then my consciousness, my brain me?"Medscape General Medicine 5(4) 2003

States Oppose U.S. Ban on Reimportation of Drugs

Midwestern governors want the less expensive drugs to save money on health benefit programs for state employees and retirees and provide assistance to low-income residents.Drug Benefit Trends 15(11) 2003

Alternating Acetaminophen and Ibuprofen in the Febrile Child: Examination of the Evidence Regarding Efficacy and Safety

Despite the long-term practice of alternating acetaminophen and ibuprofen in febrile children, what is the evidence base for this practice?Pediatr Nurs 29(5) 2003

Management of Severe Sepsis: Integration of Multiple Pharmacologic Interventions

Severe sepsis is an infection-induced syndrome resulting in a systemic inflammatory response that is complicated by dysfunction of at least one organ system.Pharmacotherapy 23(11) 2030

Topiramate an Adjunctive Treatment in Migraine Prophylaxis

Recent advances in the treatment of migraine have focused on medications for acute events rather than for prophylactic management.Headache 43(10) 2003

Conference Report - Antiretroviral Therapy Update From the 9th European AIDS Conference

There's always something new in HIV medicine. Read this comprehensive overview of new HIV treatment data and discussion from the 9th European AIDS Conference. Medscape General Medicine 5(4) 2003

Analysis of Healthcare Utilization Patterns and Adherence in Patients Receiving Typical and Atypical Antipsychotic Medications

Each year, 44 million Americans are affected by diagnosable mental disorders, and more than 5% of American adults are diagnosed with 'serious' mental illnesses, defined as disorders that interfere with some area of social functioning.Curr Med Res Opin 19(7) 2003

Management of Anemia of Chronic Disease in Patients With the Human Immunodeficiency Virus

Anemia is a common and debilitating condition associated with human immunodeficiency virus (HIV) infection and can be caused by a multitude of factors.Pharmacotherapy 23(11) 2003

Systemic Antifungal Therapy: New Options, New Challenges

The frequency of invasive mycoses has increased dramatically during the past 2 decades owing to medical advances such as intensive cancer chemotherapy, broad-spectrum antimicrobial therapy and invasive medical devices, and bone marrow and solid organ transplantation, as well as to the human immunodeficiency virus (HIV) disease epidemic and an expanding aging population.Pharmacotherapy 23(11) 2003

Impact of Prophylactic I.V. Magnesium on the Efficacy of Ibutilide for Conversion of Atrial Fibrillation or Flutter

Torsades de pointes (TdP) is a potentially life-threatening ventricular arrhythmia that can be precipitated by inhibition of the rapid component of the delayed rectifier potassium channel (IKr).Am J Health-Syst Pharm 60(22) 2003

Ergoloid Mesylates for Dementia

Do these agents have utility in the management of Alzheimer's disease or other dementias?Medscape Neurology & Neurosurgery 5(2) 2003

Selecting Appropriate IGIV Therapy

Human intravenous immunoglobulin (IGIV) can vary widely in how it is manufactured and those variations may affect clinical utility. Learn more about variations in production of IGIVs.

Recent Advances in Epilepsy Monotherapy: An Expert Interview With Gruenthal, MD, PhD

From AES '03: How can patients with epilepsy receive simplified therapy that might enhance compliance, efficacy, and adverse events? Read about it here.

Utilization Patterns and Net Direct Medical Cost to Medicaid of Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder characterized by symptoms of abdominal pain and discomfort and altered bowel function (constipation, diarrhea, or both in alternation) in the absence of organic disease.Curr Med Res Opin 19(8) 2003

NEWS

New Law Mandates More Testing of Drug Safety in Children

Advocates say law gives physicians more information about efficacy and proper dosages for the pediatric population. Medscape Medical News 2003

New Drug Ad Rules Coming Soon, US FDA Chief Says

U.S. health officials in the coming weeks will unveil new formats for television commercials and magazine advertisements that drug makers use to promote their medicines to consumers, Food and Drug Administration Commissioner Mark McClellan said on Friday.Reuters Health Information 2003

US FDA Testing Quicker Drug Development Systems

U.S. regulators are testing ways to help speed drug development, such as allowing companies to submit applications in pieces to get early feedback, Food and Drug Administration Commissioner Mark McClellan said on Friday.Reuters Health Information 2003

FDA Contacts Credit Card Companies on Drug Imports -- WSJ

The U.S. Food and Drug Administration has contacted credit card companies and package carriers to help the agency control unapproved prescription drug imports, the Wall Street Journal said on Tuesday.Reuters Health Information 2003

EU Parliament Adopts Pharmaceutical Compromise

The European Parliament adopted a compromise package of pharmaceutical legislation on Wednesday in the hope that the measures will come into force before EU enlargement next year.Reuters Health Information 2003

FDA Considers Nonprescription 'Morning-After Pill'

Staffers at the U.S. Food and Drug Administration have backed making a "morning after" pill available without prescription, saying it would provide more timely access to the emergency contraceptive drug.Reuters Health Information 2003

FDA Panel Backs Easier Access to Morning-After Pill

A U.S. advisory panel on Tuesday voted to recommend allowing the Plan B "morning-after" contraceptive pill to be sold without a prescription.Reuters Health Information 2003

Appeals Court Sets Aside Federal Marijuana Law

A federal appeals court allowed two very sick California women on Tuesday to use marijuana, setting aside long-standing federal drug laws that bar such use even for medical purposes.Reuters Health Information 2003

Medicare Low-Income Drug Benefit May Reach Fewer Than Expected

The Medicare prescription drug law signed by President Bush last week could provide more than $190 billion over the next 10 years to help an estimated 14.1 million low income seniors and disabled individuals pay for their medications. But getting that benefit to those eligible will not be easy, analysts said at a briefing Monday.Reuters Health Information 2003

Access to Morning-After Pill Stirs U.S. Debate

A panel of U.S. scientific advisers deciding whether a "morning after" contraceptive pill should be available without prescription was told by opponents on Tuesday it could put women's health at risk, while supporters hailed the possible move.Reuters Health Information 2003

Modafinil Helpful in Sleep Apnea

In a 12-week, open-label study, this drug was effective and well tolerated as adjunct therapy.Medscape Medical News 2003

& Accused of Breaking UK Advertising Laws

& 's UK subsidiary on Thursday was accused of--and immediately denied--promoting its contraceptive patch Evra in breach of English laws against direct-to-consumer advertising.Reuters Health Information 2003

Estrogen Plus Progestin Doubles Risk of Venous Thrombosis

Age and BMI are determinants of increased risk, according to a new analysis of data from the Women's Health Initiative.Medscape Medical News 2003

COX-2 Inhibitors May Not Be Cost-Effective--Study

New research by US investigators suggests that practice pattern models may have overestimated the cost-effectiveness of selective COX-2 inhibitors, such as celecoxib (Celebrex) and rofecoxib (Vioxx).Reuters Health Information 2003

Interferon Markedly Improves Lung Function in Steroid-Resistant Asthmatics

Treatment with interferon-alpha is associated with dramatic clinical benefits in patients with corticosteroid-resistant asthma, new research shows. Moreover, these benefits occur even in patients who have progressed to Churg-Strauss syndrome.Reuters Health Information 2003

Esomeprazole Most Effective for Gastric Acid Control

In a 5-way crossover study, this proton pump inhibitor was the most effective in patients with symptoms of gastroesophageal reflux disease.Medscape Medical News 2003

Valsartan and Amlodipine Have Disparate Effects on Renal Hemodynamics

For patients with essential hypertension, the angiotensin-I receptor blocker valsartan and the calcium channel blocker amlodipine control blood pressure equally well, but have markedly different effects on the renal system, according to German researchers.Reuters Health Information 2003

Efalizumab Helpful for Severe Plaque Psoriasis

Although this drug improved clinical end points in a randomized trial, the editorialists warn about risks and suggest that it should be reserved for patients refractory to established therapies. Medscape Medical News 2003

Rotigotine May Be Helpful in Parkinson's Disease

In a randomized, double-blind, placebo-controlled trial, transdermal rotigotine was safe, well tolerated, and improved symptoms in Parkinson's patients. Medscape Medical News 2003

U.S. Buys Chiron, Wyeth Flu Vaccines

The U.S. Health and Human Services Department said on Monday it had contracted to buy 375,000 doses of influenza vaccine from Chiron Corp. and had negotiated a good price for 3 million doses of a second vaccine, FluMist, for any states that want to buy it.Reuters Health Information 2003

Roche Gets FDA Nod to Label Obesity Drug for Teens

Roche Holding AG said on Monday the U.S. Food and Drug Administration approved labeling of its Xenical medicine for prescription weight loss by obese teenagers.Reuters Health Information 2003

Medicis Wins US OK for Wrinkle-Filling Shot

Medicis Pharmaceutical Corp. said Friday it won U.S. approval to sell an injectable gel for temporarily filling facial wrinkles.Reuters Health Information 2003

EU Lawmakers Set to Pass New Pharma Laws

European Union lawmakers are set to vote through three pieces of pharmaceutical legislation this week, in a compromise in the battle between research-based and generic drug firms, political groups told Reuters on Monday.Reuters Health Information 2003

Clioquinol May Be Helpful in Alzheimer's Disease

In a pilot study, this metal chelator reduced progression of Alzheimer's disease compared with placebo.Medscape Medical News 2003

Etanercept Monotherapy Helpful in Psoriasis

In a randomized, placebo-controlled trial, this treatment was effective and had a favorable safety profile.Medscape Medical News 2003

Treatment Protocol With Arsenic and Retinoic Acid Highly Effective for APL

Combination therapy improves response rates more than use of either agent alone in patients with acute promyelocytic leukemia.Medscape Medical News 2003

Millennium Ends Velcade Cancer Drug Trial Early

Millennium Pharmaceuticals Inc. said on Monday it is ending a phase III clinical trial of Velcade (bortezomib) due to the drug's early success in treating multiple myeloma.Reuters Health Information 2003

Some Consumer Ads for Aventis' Taxotere Misleading, U.S. FDA Charges

U.S. regulators told drugmaker Aventis to stop circulating misleading ads about a cancer drug and to take steps to correct false impressions consumers may have received, according to a letter made public on Thursday.Reuters Health Information 2003

Transdermal Rotigotine Safe and Effective for Early Parkinson's Disease

The selective D2-dopamine receptor agonist rotigotine delivered through a silicone-based transdermal patch safely improves motor signs in patients with Parkinson's disease (PD), investigators report in the Archives of Neurology for December.Reuters Health Information 2003

Gets Subpoena From U.S. Government

Pharmaceuticals Inc. said on Friday it received a subpoena from the U.S. Department of Health and Human Services related to promotional meetings with physicians about its drug for iron deficiency anemia.Reuters Health Information 2003

Adverse Reactions to One TNF Blocker Do Not Preclude Trying Another

Another study has shown that patients with rheumatoid arthritis (RA) who fail one tumor necrosis factor alpha (TNF-alpha) blocker may respond to a different one. Reuters Health Information 2003

Androgen Suppression for Prostate Cancer Alters Cognition Somewhat

Combined androgen blockade as therapy for prostate cancer appears to have mixed, but minor, effects on cognitive function, researchers report. Spatial ability may be impaired but verbal memory seems to be improved.Reuters Health Information 2003

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