1. News You Can Use… Pete Koval, PharmD Christina Adler, PharmD candidate Cone Health Family Medicine December 2014

2. Pradaxa vs Warfarin Two new studies have shown that Pradaxa has an increased risk of GI bleeding and major bleeding compared to warfarin The risk is greatest at the higher 150 mg twice daily dose One study found the risk is greatest in patients with CKD and those who are African American 11/05/2014 Web MD

3. COX-2 Inhibitors and Stroke Cox-2 inhibitors have been found to increase the risk of dying from stroke Current users were 19% more likely to die after stroke than non-users New Users were 42% more likely to die after stroke compared to non-users Avoid prescribing in patients with high risk of stroke 11/06/2014 Medical News Today

4. New FDA Approval Hysingla ER (hydrocodone barbiturate) is an FDA approved pain medication with abuse-deterrent properties Can not easily be crushed, broken or dissolved and forms a viscous hydrogel May be cost prohibitive 11/20/14 FDA News Release

5. Flu Vaccine in Children Three studies conducted during the 2013-2014 flu season found FluMist the live attenuated vaccine ineffective against H1N1 in children 2-8 years old. The CDC has not changed its recommendation that FluMist is preferred in children 2-8 years old. 11/13/14 Facts & Comparisons News Brief

6. Outcomes Data for Zetia Zetia (ezetimibe) plus a statin has been shown to decrease CV events in high risk patients with ACS. IMPROVE-IT Trial not yet published but is coming very soon Reportedly there was a 6.4% risk reduction with the combination compared to statin alone

7. New Guidelines Published The American Gastroenterological Society published new guidelines for IBS in Gastroenterology More guidance on first line options for IBS-C and IBS-D A rigorous and evidence based summary of the drug literature