Adam Corey, PharmD Candidate Cone Health Family Medicine News You Can Use… Adam Corey, PharmD Candidate Pete Koval, PharmD Cone Health Family Medicine November, 2016

Rx-to-OTC Switch Adapalene Gel First OTC retinoid for Acne Remains Pregnancy Category C – Consult a physician before use if pregnant or plan on becoming pregnant ADEs – redness, stinging, burning, hyperpigmenation, photosensitivity http://pharmacytoday.org/article/S1042-0991(16)30799-X/fulltext

CDC Vaccine Update Changes to HPV Vaccine Doses Ages 11-15 – only need 2 doses Administer doses at least 6 months apart Ages ≥15 – continue 3 dose schedule http://www.cdc.gov/media/releases/2016/p1020-hpv-shots.html

FDA Black Box Update Direct Acting Antivirals (DAA) for Hepatitis C drugs must have Boxed Warning for Hepatitis B reactivation Screen all patients for current or prior HBV infection before starting DAA Monitor for flare-ups or reactivation of HBV during and after treatment Counsel patients to call if: fatigue, weakness, loss of appetite, yellowing of eyes/skin or light-colored stools http://www.fda.gov/Drugs/DrugSafety/ucm522932.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery

FDA Approval FDA approves Meditronic’s MiniMed 670G closed loop system 1st automated insulin delivery device for T1DM Automatically monitors blood glucose ever 5 minutes and delivers or holds insulin dose Approved for ages 14 years and older http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm522974.htm

Article Review Calcium-channel blockers and beta blockers doubled the risk of hospitalizations for MDD and Bipolar compared to ACE/ARB CCB increased risk 2.28x (p<0.05) BB increased risk 1.93x (p<0.05) ACE Inhibitors and ARBs showed no difference or reduced risk Boal A, Smith D, McCallum L, Muir S, Touyz R, et al. Hypertension 2016; 68:1132-38

DEA Update DEA drops plans to make Kratom a Schedule 1 substance Used as alternative to opioids in chronic pain– induces pain relief and mild euphoria, with less respiratory depression ADEs: aggression, hallucinations, delusions, insomnia, nausea, hypothyroidism, seizures and severe withdrawal from habitual use Currently, 6 states ban Kratom or components Natural Medicines (2016): Kratom. From http://www. naturalmedicines.therapeuticresearch.com http://www.npr.org/sections/health-shots/2016/10/12/497697627/kratom-gets-reprieve-from-drug-enforcement-administration

FDA Warning FDA adds warnings to testosterone and other anabolic androgenic steroids for the treatment of low testosterone Update to Abuse and Dependence Section Due to safety risks affecting the heart, brain, liver, mental health and endocrine Recommends monitoring testosterone concentration if abuse is suspected http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm526151.htm

FDA Approval Zinplava® (Bezlotoxumab) For adults taking one medication for C. difficile Infection at high risk for re-infection Dose: 10 mg/kg IV over 1 hour MoA: Binds and Neutralizes Toxin B ADEs: Nausea, Pyrexia, Headache, Heart Failure Exacerbation Zinplava® [Package Insert] Whitehouse Station, NJ: Merck & Co; 2016