Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

Purpose: The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described.

Summary: Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls.

What is the most effective therapy for preventing NSAID-induced gastropathy?

Nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal toxicity is associated with morbidity and mortality, and given the very wide use of NSAIDs, is problematic and costly to society. Several options are now available to minimize gastrointestinal toxicity from NSAIDs. These options include the proton pump inhibitors, misoprostil, double-dose H2-receptor blockers and the COX-2 selective NSAIDs.

Removing meperidine from the health-system formulary--frequently asked questions.

Meperidine is FDA-approved for relieving moderate to severe pain and has been widely used since its introduction in the 1930s. However, the drug is no longer considered a first-line analgesic. Many clinicians recommend that meperidine be removed from health-systems or that its use be restricted, due to concerns about adverse reactions, drug interactions, and normeperidine neurotoxicity.

Newer anticonvulsant drugs in neuropathic pain and bipolar disorder.

Older anticonvulsants have been used to manage both chronic pain and bipolar disorders. As the armamentarium of anticonvulsants increases, the role of the newer agents for pain or mood disorders is uncertain. This paper summarizes the clinical data available with gabapentin, lamotrigine, oxcarbazepine, tiagabine and topiramate for bipolar disorder and lamotrigine, oxcarbazepine, tiagabine and topiramate for neuropathic pain.

Hepatotoxicity of the thiazolidinediones.

Troglitazone, the first of the thiazolidinediones, caused severe hepatotoxicity including liver failure in several patients. It appears, however, that the thiazolidinediones as a class are not as hepatotoxic as troglitazone. Comparative data at comparable dates of usage indicate that pioglitazone and rosiglitazone are not significant hepatotoxins.