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Every article tells you what's new - and gives you a quick review. Scores of articles cover top-selling drugs and common health conditions.

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Drug Therapy Updates & Reviews/CE View All
  • Osteoarthritis (OA) – also called degenerative joint disease – is the most common chronic joint condition, affecting about 27 million Americans. The resulting pain, stiffness, and swelling can affect mobility, productivity, and quality of life.

    While no treatment has been shown to slow the progression of joint damage, a combination of non-drug interventions and drug therapy can be used to manage symptoms and improve mobility. Resistance exercise, weight loss, and psychosocial interventions are among the non-drug interventions recommended for osteoarthritis patients. Recommended drug therapies include acetaminophen, oral and topical nonsteroidal antiinflammatory drugs (NSAIDs), tramadol, and intra-articular corticosteroid injections. The American College of Rheumatology (ACR) provides recommendations for the management of hand, knee, and hip OA.3 The American Academy of Orthopaedic Surgeons (AAOS) provides somewhat different recommendations for the management of knee and hip OA. Drug therapy recommendations are summarized in the Appendix.

    This issue will focus on oral medications and complementary therapies commonly used for the treatment of OA – particularly OA of the knee, hip, and hand – based on ACR and AAOS guidelines,3-5 as well as other evidence-based literature.

  • The American Diabetes Association (ADA) updates their practice guidelines every year, incorporating new data that can have a significant impact on patient health, care, and outcomes. Each January for the past 26 years, the ADA has published these guidelines as the Standards of Medical Care in Diabetes, referred to simply as the “Standards of Care.” This publication is the go-to reference guide for many healthcare professionals who care for people with diabetes. It provides practitioners, patients, researchers, and payers with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care.

    While healthcare providers may focus on managing glucose, blood pressure, and lipid goals in patients with diabetes, the cornerstone of therapy is Diabetes Self-Management Education and Support (DSME/S), which engages the patient in active collaboration with the healthcare team Self-management is an ongoing, lifelong process that does not stop after each healthcare visit...

  • The Healthy People 2020 report, published by the US Department of Health and Human Services, includes targets for reducing vaccine-preventable disease rates and increasing vaccination rates in all age groups. According to the report, for each birth cohort (group of individuals born in the same year), immunization with the routine childhood vaccination schedule prevents 14 million cases of disease and reduces direct healthcare costs by $9.9 billion. Vaccines are one of the most cost-effective clinical preventive services; however, thousands of people in the US do not receive them and suffer – even die – from vaccine preventable diseases. From 2010 through 2014, flu-related deaths in the US ranged from 12,000 to 56,000 per year. Pneumococcal pneumonia leads to about 19,000 deaths every year, and as many as 1.4 million people currently suffer from Hepatitis B, with liver cancer as a potential complication. There have been a number of recent measles and pertussis outbreaks in communities with pockets of unvaccinated and under-vaccinated children.

    In order to meet the Healthy People 2020 targets, all healthcare providers should stay up-to-date on vaccine recommendations and play an active role in immunizations. The Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) update their recommendations for routine immunizations annually, while vaccine-specific recommendations are typically updated every 3-5 years (except influenza, which is updated yearly). Additionally, the CDC publishes the General Recommendations on Immunization and the Epidemiology and Prevention of Vaccine-Preventable Diseases (known as “The Pink Book”), which are considered core references for vaccine providers...

  • The past few years have seen a number of legislative and regulatory changes at the federal level; both with the Food and Drug Administration (FDA) and the Drug Enforcement Administration (DEA). This article will address key changes impacting pharmacy practice in the areas of compounding, drug supply chain security, biosimilars, and the regulation of controlled substances in order to prevent diversion and abuse.

    The passage of the Drug Quality and Security Act of 2013 (DQSA) updates the Federal Food, Drug, and Cosmetic Act (FDCA) in the areas of human drug compounding and drug supply chain security.1 Previously, compounding was mostly regulated by individual states under section 503A of the FDCA. In the years to come, the FDA will continue to clarify regulations surrounding compounding and drug supply chain security.

    The FDA has developed policy regarding biological medications, particularly around nearly identical biological products (biosimilars) and their therapeutic substitution. A new online publication called the “Purple Book” lists biological products, and specifies those that are biosimilar and/or interchangeable....

    2.0 Hours Pharmacy Law CE - 0.20 CEU. Target Audience: pharmacists, nurses, nurse practitioners, advanced practice nurses and pharmacy technicians.

  • After a record-setting 45 approvals in 2015, the FDA approved only 22 new molecular entities in 2016.1 The FDA’s Office of New Drugs gave 3 explanations for the drop off: 1) 5 drugs with 2016 due dates were approved ahead of schedule in 2015; 2) biopharmaceutical companies filed fewer applications in 2016; and 3) there were more rejections. Of the 22 novel drugs, almost one third received breakthrough therapy designation, about two thirds were given priority review, and more than one third were for rare diseases. Two of the novel agents, elbasvir/grazoprevir and sofosbuvir/velpatasvir, were discussed in The Rx Consultant November 2016 issue on hepatitis C.

    This issue reviews 8 novel drugs: crisaborole – the first topical phosphodiesterase 4 inhibitor for atopic dermatitis; ixekizumab – the second interleukin-17A inhibitor for psoriasis; lifitegrast – a first-in-class ophthalmic agent for dry eye disease; pimavanserin – the first drug to be approved for Parkinson’s disease psychosis; and 4 cancer drugs – atezolizumab for bladder and lung cancer, olaratumab for soft tissue sarcoma, rucaparib for ovarian cancer, and venetoclax for chronic lymphocytic leukemia Prasterone, a new option for a common postmenopausal disorder, is also reviewed. The 4 cancer drugs received accelerated approval; this means that their continued approval may depend on confirmation of benefit in further studies. Usual doses and selected drug interactions are summarized in Table 1. Nine more new drugs or new dosage forms that may be encountered in every day practice are described in Table 2. Both tables include pronunciation guides and brand names...

    2.0 Hours Pharmacotherapy CE - 0.20 CEU. Target Audience: pharmacists, nurses, nurse practitioners, advanced practice nurses and pharmacy technicians.

  • This CE activity meets the Florida Board of Pharmacy requirement for a Board-approved 2-hour continuing education course on the Validation of Prescriptions for Controlled Substances. It also meets other state board requirements for a continuing education course on patient safety.

    The appropriate and safe management of pain, and concerns about opioid overuse, abuse and overdose, have been making headlines for the past 20 years. Historically, opioids have been used for chronic non-cancer pain despite a lack of high-quality evidence for efficacy. Pain management societies and organizations (eg, THE Joint Commission on Accreditation of Healthcare Organizations [JCAHO]) embraced pain as a “vital sign” in the mid-1990s and encouraged more aggressive use of opioids for chronic pain. The amount of prescription opioids sold in the US increased nearly 4-fold from 1999 to 2014, despite no increase in reported pain.

    According to IMS Health, a firm that tracks national prescription statistics, the number of opioid prescriptions dispensed peaked in 2012. For the first time in 20 years, the IMS data indicated a 12% overall decline in US opioid dispensing since the peak. Tightening of federal regulations for opioid prescriptions (eg, moving hydrocodone to schedule II status) likely contributed to the decline. Experts note, however, that the level of prescribing is still very high – with a growing overdose epidemic including fatal overdoses, which reached 28,000 in 2014.

    Regulators and the public are looking to clinicians to "do the right thing" regarding pain management, but the "right thing" has been a moving target. What actions are in the patient’s or public’s best interest, and in the best interest of the clinician and their professional practice? There are opposing pressures from 1) patients and pain management experts who advocate providing opioids for individuals with pain, and 2) families, caregivers, and regulatory officials, who want to prevent prescription drug diversion, abuse and overdose. Finding the right balance to provide safe and effective pain management is a “moral imperative,” professional responsibility, and duty of healthcare professionals.

Pharmacists: Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Advanced Practice Nurses : (Nurse Practitioners and Clinical Nurse Specialists): CE hours provided by Continuing Education Network (in The Rx Consultant) meet the ANCC criteria and the AANP criteria for formally approved continuing education hours. Click here for more information about the ANCC criteria. Click here for more information about the AANP criteria.

Registered Nurses : Click here for specific information on acceptance of CE from The Rx Consultant by your state Board of Registered Nursing.