Download Drug Information Updates 2010 update to diabetes guidelines

January 2010
Volume 2, issue 1
Drug Information Updates
2010 update to diabetes guidelines
The American Diabetes Association
have published revisions to their
Clinical Practice Recommendations
for 2010.
One of the more prominent
revisions to the Clinical Practice
Recommendations is the inclusion of
a new diagnosis criteria for diabetes,
the use of A1C ≥ 6.5% as a diagnosis
for diabetes. Furthermore, an A1C
of 5.7—6.4% has been added to the
previous impaired fasting glucose
and impaired glucose tolerance for
criteria of patients at an increased
risk of developing diabetes in the
future.
The antiplatelet agents section has
also been revised due to recent data
from trials. The ADA now
recommends the use of aspirin for
primary prevention in patients at
increased risk for a cardiovascular
event (10-year risk >10%), including
men over the age of 50 and women
over the age of 60 with at least one
other major risk factor.
Other sections that have been
revised include: detection and
diagnosis of GDM, diabetes selfmanagement education, retinopathy
screening and treatment, diabetes
care in the hospital, and strategies
for improving diabetes care.
Lastly, a new section on diabetes
care in patients with cystic fibrosis
has been added.
National Influenza Vaccination Week
The CDC is sponsoring the National Influenza Vaccination Week (NIVW)
to take place from January 10th through January 16th. NIVW was developed
to address the importance of vaccination against influenza, even after the
holiday season. Each day of the week is set aside to emphasize the
importance of certain groups in the community to get vaccinated. For more
detail and a schedule of daily events, visit http://www.cdc.gov/h1n1flu/
nivw/.
Newly Approved Drugs
Tocilizumab (Actemra®)
Class: Interleukin-6 (IL-6) receptor inhibitor
Indication: Treatment of rheumatoid arthritis
MOA: Actemra® is an antagonist of the IL-6 receptor, inhibiting IL-6
signaling. IL-6 plays a part in a variety of immune responses. Inhibition
of IL-6 by Actemra® reduces levels of cytokines and production of acute
reactants responsible for rheumatoid arthritis.
BBW: Risk of serious infection, including tuberculosis
Interactions: May increase metabolism of drugs via restoring CYP450
back to higher levels.
Doses available - Single-use vials: 80mg/4ml, 200mg/10ml, 400mg/20ml
SIUE School of
Pharmacy
Special points of interest:
> DM guidelines update
> Newly Approved Drugs
> New Formulations
> New generics
Page 2
Drug Information Updates
Capsaicin 8% patch (Qutenza®)
Class: TRPV1 channel agonist (topical analgesic)
Indication: Management of neuropathic pain associated with
postherpetic neuralgia.
MOA: Causes initial enhanced stimulation of TRPV1 receptors (may be
painful at first). Pain relief is achieved later by reducing the number of
TRPV1 receptor containing neurons.
Interactions: Studies of drug interactions have not been performed. In
vitro studies have shown that capsaicin does not inhibit nor induce
CYP450 enzymes.
Doses available: Patch 8% capsaicin (179 mg capsaicin)
Dalfampridine (Ampyra®)
Class: Potassium channel blocker
Indication: Improvement of walking in patients with multiple sclerosis.
MOA: Mechanism of action is not known. It is thought to increase
conduction of action potentials through demyelinated axons by blockage
of potassium channels.
Interactions: Few drug interaction studies have been performed. No
drug interactions have been found thus far.
Doses available: Tablet 10 mg
Liraglutide (Victoza®)
Class: Glucagon-like peptide-1 (GLP-1) receptor agonist
Indication: Adjunct to diet and exercise to improve glycemic control in
adults with type 2 diabetes mellitus.
MOA: Increases release of insulin in presence of elevated serum glucose
levels. Increased release diminished as serum glucose levels decrease.
Also, decreases glucagon secretion and gastric emptying time.
Interactions: Limited drug interaction studies have shown low potential
for drug interactions related to CYP450 enzymes.
Doses available: Prefilled, multi-dose pen (6mg/ml, 3 ml).
Ecallantide (Kalbitor®)
Class: Plasma kallikrein inhibitor
Indication: Treatment of acute attacks of hereditary angioedema in
patients > 16 years old.
MOA: Selective, reversible inhibitor of plasma kallikrein. Binds to and
blocks binding sites of kallikrein, inhibiting the conversion of kininogen
to bradykinin.
Interactions: No drug interaction studies or in vitro metabolism studies
have been performed.
Doses Available: Single use vial 10mg/ml
Page 3
Volume 2, issue 1
Tranexamic acid (Lysteda®)
Class: Antifibrinolytic agent
Indication: Treatment of cyclic heavy menstrual bleeding.
MOA: Forms reversible bond with fibrin, displacing plasminogen. This
results in inhibition of fibrinolysis.
Interactions: No drug interaction studies have been performed with
Lysteda®. Use caution when prescribing Lysteda® to patients receiving
hormonal contraceptives or other medications that increase risk of
thrombotic events. Benefit should outweigh risk.
Doses available: Tablet 650 mg
Ofatumumab (Arzerra®)
Class: CD20 directed cytolytic monoclonal antibody
Indication: Treatment of refractory chronic lymphocytic leukemia
(CLL).
MOA: Binds to the CD20 molecule expressed on B lymphocytes. This
results in lysis and toxicity in cells overexpressing CD20.
Interactions: No formal drug-drug interactions have been performed
with Arzerra®.
Doses available: Single use vial 100mg/5ml.
New Formulations and Indications
Generic name:
Papillomavirus
(Types 6, 11, 16,
18) Vaccine
Brand name:
Gardasil®
New Indication:
Prevention of
genital warts in
men and boys age
9 to 26.
Generic name:
Pregabalin
Brand name:
Lyrica®
New Dosage
Form: Oral
solution 20mg/ml.
Generic name:
Olanzapine
Brand name:
Zyprexa®
Relprevv™
New Dosage
Form: Extended
release injection
of schizophrenia
SIUE School of Pharmacy
New Generic drugs (since October 2009)
Generic
Brand
October
Fentanyl Citrate Troche/Lozenge
Buprenorphine sublingual tablet
Chlorothiazide injection
October
Actiq®
Subutex®
Sodium Diuril® injection
November
Ketorolac Tromethamine
ophthalmic solution
Perindopril Erbumine
Nicardipine Hydrochloride
Ethinyl Estradiol and norethindrone
Lansoprazole
November
Acular® and Acular LS ®
December
Donepezil ODT
December
Aricept® ODT
January
Ibutilide Fumarate
January
Corvert®
Aceon®
Cardene®
Femhrt® 1/5
Prevacid®
.