The Pharmacist’s News Source
pharmacypracticenews.com
Volume 39 • Number 6 • June 2012
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4 0th A N N IV E RSA RY
Young Cancer Patients in this issue Front Getting More Attention Up In Brief Orlando, Fla.—In recent years, a niche of medicine has sprung up to address the needs of adolescents and young adults (AYA) with cancer. AYA oncology now has its own society and its own journal, and in March, the National Comprehensive Cancer Network (NCCN) issued its first set of AYA guidelines. The attention to AYA cancer patients—defined as those aged 15 to 39 years—is sorely needed. In the past 40 years, cancer survival rates of children and older adults has improved significantly, whereas survival rates among AYAs with cancer have barely budged. “Improvements in cancer survival among AYA patients definitely have lagged behind other sectors of the population,” said Kerry Parsons, PharmD, a pediatric oncology pharmacist at Children’s of Alabama, in Birmingham, who discussed AYA oncology at the annual meeting
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see YOUTH CANCER, page 9
Pharmacists Employ Cost-Saving Strategies For Pricey New Drugs Orlando, Fla.—These days, cancer centers across the United States are doing everything they can to contain costs. At the annual meeting of the Hematology/Oncology Pharmacy Association (HOPA), pharmacists presented strategies for reducing costs involved with ipilimumab (Yervoy, Bristol-Myers Squibb) and rasburicase (Elitek, Sanofi-aventis).
Cost Cutting With Ipilimumab A study by researchers from the Roswell Park Cancer Institute in Buffalo, N.Y., demonstrated that dose rounding of ipilimumab to the nearest 50 mg has the potential to result in a significant cost savings without adversely affecting patient care (abstract 9). Ipilimumab was approved in March 2011 for the treatment of metastatic melanoma at a dose of 3 mg/kg every 21 days for four doses. The drug is supplied as 50- or 200-mg single-use vials, each
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see STRATEGIES, page 8
Anticonvulsant may help relieve cannabis dependence.
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Policy
USP <Chapter 797> Tips for preventing contamination in sterile compounding settings.
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Clinical
Hem/Onc Pharmacy “Dont ask, don’t tell” doesn’t work with dietary supplements.
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Extended docetaxel infusion slashes adverse reactions.
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Critical Care Neuromuscular blockers cut mortality in ICU.
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Steroids speed extubation in septic shock patients.
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Operations & Mgmt
Wicked Change Envisioning a new practice future.
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Reimbursement Matters How to get your fair share of bundled payments.
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Leadership in Action Conflict: the destroyer or an opportunity?
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Educational Review
Managing Anemia in Patients With Chronic Kidney Disease See insert after page 16
Heart Failure Checklist Decreases Readmissions Physicians and pharmacists develop tool to keep HF patients healthy and at home Chicago—An inexpensive checklist used at discharge has virtually eliminated 30-day readmissions for heart failure (HF) in a Michigan hospital. At six months, the benefits of the strategy still held strong, with nearly twice as many patients staying at home after undergoing checklist-driven interventions, according to a poster study presented at the annual meeting of the American College of Cardiology. “The study has huge significance,” Abhijeet Basoor, MD, a cardiology fellow at St. Joseph Mercy Oakland Hospital, in Pontiac, and lead author of the study, told Pharmacy Practice News. “With such an inexpensive tool, you can improve quality of care and decrease readmissions.” The checklist can help hospitals achieve another important goal: steering clear of financial penalties that the Centers for Medicare & Medicaid Services (CMS) will assess on facilities that are deemed to have excessive readmission rates for HF and other conditions. The penalties are scheduled to take effect Oct. 1, 2012, according to a CMS press release.
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see READMISSION, page 23
Vancomycin Plus Piperacillin-Tazo May Trigger Acute Kidney Injury Houston—As many as 50% of patients treated with the combination of vancomycin and piperacillin-tazobactam (Zosyn, Wyeth) experience acute kidney injury, according to two studies presented at the annual meeting of the Society of Critical Care Medicine (SCCM). Piperacillintazobactam on it own also posed a safety risk, with the drug appearing to be more nephrotoxic than vancomycin. “We have been taught that vancomycin causes a lot of renal failure,” said
Thaddaus Hellwig, PharmD, an assistant professor of pharmacy practice at South Dakota State University College of Pharmacy, in Brookings, and an author of one of the studies. However, based on the new data, “maybe we should be keeping a little closer eye on patients [taking] Zosyn,” he said. Dr. Hellwig and his colleagues retrospectively studied (abstract 301) all patients aged 18 years and older who
The Book Page
New Product
Applied Biopharmaceutics & Pharmacokinetics, Sixth Edition Leon Shargel, Andrew Yu, Susanna Wu-Pong See page 31.
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see NEPHROTOXICITY, page 13
CutisPharma offers two new compounding kits. See page 10.