Presentation on theme: "Matthew Lacroix Pharm.D BCPS Assistant Professor University of New England College of Pharmacy April 26, 2014."— Presentation transcript:
Matthew Lacroix Pharm.D BCPS Assistant Professor University of New England College of Pharmacy April 26, 2014
Objectives Pharmacists objectives 1. Discuss the basic pharmacology of the new drugs presented and how the pharmacologic actions relate to both therapeutic and adverse effects. 2. Discuss clinically significant adverse effects and drug interactions, and the appropriate dosing and monitoring of the new drugs presented. 3. Discuss the therapeutic role of the new drugs presented as compared to agents already marketed. Technician objectives 1. List the new drugs presented. 2. Describe clinically significant adverse effects and drug interactions, and the appropriate dosing and monitoring of the new drugs presented.
Conflicts of Interest Dr. Lacroix has no conflicts to report
Best resource for new drug release Pharmacist Letter http://pharmacistsletter.therapeuticresearch.com/ pl/NewDrugs.aspx?cs=&s=PL&pt=20&yr=2013 http://pharmacistsletter.therapeuticresearch.com/ pl/NewDrugs.aspx?cs=&s=PL&pt=20&yr=2013 Tend to highlight most important new agents, new formulations, and new biologics
Q2) Estrogens (conjugated/equine) and Bazedoxifene is a combination of what two classes of medications? 1) estrogen derivatives and SERM 2) estrogen and progestogen 3) estrogen and SSRI 4) estrogen and SNRI
Q6) Simeprevir and and sofosbuvir are new medications introduced for the treatment of what disease at the end of 2013? 1) COPD 2) Menopause 3) Hepatitis C 4) bipolar disorder
Hepatitis C Simeprevir (Olysio) Oral: 150 mg once daily (in combination with peginterferon alfa and ribavirin). Treatment duration is indication and response-specific. Focus on HCV-RNA detection/undectable Cost: 150 mg (28): $26544.00 Sofosbuvir (Sovaldi) Oral: 400 mg daily with concomitant ribavirin and with or without peginterferon alfa (maximum: 400 mg daily). Genotype specific for duration requirements Costs : 400 mg (28): $33600.00
Hydrocodone (Zohydro ER) New stand alone product Highly controversial Starting dose is 10mg in opioid naïve patients and titrated up q3-7 days Side effects are similar to hydrocodone/APAP with less liver side effects C-II
Hydrocodone (Zohydro ER) Conversion from transdermal fentanyl: Treatment with hydrocodone ER may be started 18 hours after the removal of the fentanyl transdermal patch. For every fentanyl 25 mcg per hour transdermal patch, initially substitute hydrocodone ER 10 mg every 12 hours. Monitor the patient closely. Previous Oral Opioid Oral Dosage Approximate Oral Conversion Factor 2 Hydrocodone10 mg1 Oxycodone10 mg1 Methadone 3 10 mg1 Oxymorphone5 mg2 Hydromorphone3.75 mg2.67 Morphine15 mg0.67 Codeine100 mg0.1 1 Approximate equivalent doses for conversion from current opioid therapy to hydrocodone ER. 2 Ratio for converting oral opioid dose to approximate hydrocodone ER equivalent dose. 3 Monitor closely; ratio between methadone and other opioid agonists may vary widely as a function of previous drug exposure. Methadone has a long half-life and may accumulate in the plasma.