Pharmaceutical News 2.0

Have you ever received a hospital bill and wondered why the medications you were given during your stay seemed to cost more than the same medications purchased from your community pharmacy?

There are many reasons for that. First, patients who are treated in hospitals tend to be sicker, often requiring expensive and intensive therapy for critical conditions.

The medications you receive in a hospital are also accompanied by a heavy dose of round-the-clock expert care. A dedicated team of physicians and pharmacists continually monitors and adjusts your medications to help you get better.

This close attention to how your body reacts to all the medications you are receiving is an important part of hospital care. The prescription drug warfarin is an example of the importance of monitoring. Although this is an inexpensive blood thinner, hospital patients who take warfarin daily must be monitored by a pharmacist to make sure that their blood doesn’t get too thin. Likewise, nonprescription medicines like aspirin can cause real problems when paired with other medications while you are hospitalized.

Read the rest of this article on safe medication use.

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Safe medication practices promote patient safety, enhance the results of medication use and reduce liability loss. To achieve these goals, the following principles are offered to assist physicians to form effective therapeutic partnerships with their patients. The global intent of these principles is to identify and address actions that have been shown by experience and numerous studies to be associated with the decreased risk of undesired effects.

In an effective therapeutic partnership, the physician’s contribution is to prescribe the appropriate medication and to educate the patient about its use. The patient’s contribution is to take medications according to instructions and to re p o rt back to the physician both the positive and negative effects. (Pharmacists and nurses also have an important role in the therapeutic partnership. The focus of these principles, however, is on the relationship between the knowledgeable physician and the informed patient.)

Read the rest of this document here (PDF).

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A new study evaluates the safety and efficacy of two common classes of antidepressants used for the treatment of postpartum depression.

Selective serotonin reuptake inhibitors (SSRIs), or tricyclics, are medications used for care of general depression. While the pharmaceuticals are often used for postpartum depression, the study was the first to compare the medications specifically among women who experienced major depression after childbirth.

The investigation, led by researchers from the University Of Pittsburgh School Of Medicine is published in the August issue of the Journal of Clinical Psychopharmacology.

“We’ve been treating postpartum depression based on the assumption that drugs that work for a woman with depression under usual circumstances will work for a woman who experiences depression after giving birth, but there have not been studies that provide scientific proof that this was an effective and safe course of treatment,” said Katherine L. Wisner, M.D., M.S., professor of psychiatry and obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine. “Treating these women based on that assumption was simply not good enough, and we felt compelled to provide scientific evidence to guide postpartum depression treatment decisions.”

In the study, researchers compared the tricyclic nortriptyline and the SSRI sertraline because both drugs were proven effective in treating general depression in women. In addition, previous studies showed the two drugs were acceptable for use in breastfeeding women. Researchers interviewed 420 women who had major depression with postpartum onset at three sites: Pittsburgh, Cleveland and Louisville, Ky. Of those, 109 qualified and chose to participate in the study. They were randomized to receive either nortriptyline or sertraline. A placebo was not used, as researchers felt it would be unethical and dangerous to the mother and her infant to not treat the illness actively. Using common tools for assessment of depression, the investigators evaluated the women for remission of depressive symptoms at four, eight and 24 weeks. The latter evaluation point included only women who had responded after eight weeks. Of the original 109 participants, 95 provided response data at four weeks, 83 provided data at eight weeks, and 29 completed between 20 and 24 weeks of the study.

The proportion of women who responded with a reduction in depressive symptoms, and those who remitted, having few depressive symptoms consistent with wellness, did not significantly differ between the two drugs at any of the study’s time points. By week four, 46 percent of the participants taking sertraline had responded and 27 percent remitted, while 56 percent of those taking nortriptyline responded and 30 percent remitted. At eight weeks, 56 percent of the participants on sertraline had a reduction of symptoms and 46 percent had no symptoms, while the participants taking nortriptyline had 69 percent respond and 48 percent remit. Of the 29 participants who remained in the study until 20-24 weeks, 93 percent taking sertraline responded and 73 percent remitted, while 100 percent taking nortriptyline responded and 79 percent remitted. None of these differences were significant by statistical analyses.

Learn more about safe meds for postpartum depression.

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