Layout

Good NEWS for those trying to quit smoking!!
Beginning in September 2011, not only are Champix® and Zyban® covered by ODBF, but pharmacists
are being reimbursed for their role in counseling and support of patients who are addicted to cigarettes.
Details
• People taking Champix® (varenicline) or Zyban® (bupropion) are now covered by limited use code
423 for 12 weeks a year, provided treatment is also in conjunction with smoking cessation counselingby a health professional.
• Those whose prescriptions will be covered, include seniors, people on social • These people should also complete a minimum of nine counseling sessions with a pharmacist who has completed smoking cessation training. Studies show thatpharmacotherapy in combination with counseling sessions support increasesthe person's success rate for sustaining a smoke-free lifestyle. Let’s get all thehelp you can get for this major lifestyle change!!! How you can take advantage of the Ministry’s action plan
Simply call Medical Arts to book a free consultation with a pharmacist (613) 933-0670 (13th Street) or (613) 932-6501 (
Montreal Road) in Cornwall. Remember: Quitting smoking is the most important thing someone can do for his/her health!
Ontario’s Narcotics Strategy
Between 1991 and 2009, the number of oxycodone prescriptions in Ontario rose by 900 percent, making Ontarians the
highest users of narcotics in the world.
To tackle the problem, Ontario’s strategy wil promote the proper use of prescription narcotics and other control ed substances
while working to reduce drug abuse and addiction.
Oxycodone is well recognized as a potent and effective narcotic to relieve moderate to severe pain, and the Ministry of
Health and Long Term care wil ensure that people who need narcotics or control ed substances have access to drug therapies.
At this point, legislation has passed that wil al ow the Ministry to track narcotics and other control ed substances prescriptions,
and keep a database. However, the logistics of the application has yet to be unveiled. The strategy should roll out beginning
of 2012. To follow….
U.S Food and Drug Administration recommend to avoid simvastatin 80mg per day:
Some regulators are telling prescribers NOT to use the 80 mg dose.unless patients have been on it for a year without
myopathy.
If simvastatin 40 mg isn't enough, suggest going to atorvastatin (Lipitor, etc) 40 mg or rosuvastatin (Crestor) 10 to 20 mg.
If you have requests, suggestions or comments for future issues, your feedback may be directed to suzie@medicalartspharmacy.ca
Written by Suzie Pilon B.Sc.Phm., CDE, Certified Geriatric Pharmacist, and reviewed by Josee Lemay, Certified Geriatric Pharmcist, associate clinician at the UofM Medical Arts Pharmacy 173 Montreal Road & 30 13th Street East, Cornwall, Ontario Phone: 613-932-6501 or 613-933-0670
Stricter dosing limits are also being proposed for when simvastatin is used with other drugs that interacts with it byinhibiting its metabolism. For example, try not to exceed 20 mg/day of simvastatin with amlodipine.or 10 mg/day withamiodarone, verapamil, or diltiazem. Don't use simvastatin at all with strong CYP3A4 inhibitors.itraconazole,clarithromycin, protease inhibitors, etc.
Clarithromycin is a common drug interaction with the statins where it is warranted to HOLD simvastatin, limit the doseof atorvastatin . Pravastatin, flluvastatin or rosuvastatin seem to be safe when use with clarithromycin. As health professionals, we are facing potentially severe interactions, such as myopathy, QT prolongations etc… thatwarrant good communication between each other. The clinical pearl
A Quick overview of glycemic targets for Adults with Diabetes:
Canadian Diabetes Association (CDA) clinical practice guidelines (cpg) 2008 have adapted clear glycemic targets for
adults, children and adolescents and also pregnant women, The guidelines do not seem as clear when it comes to
elderly with multiple comorbidities, a high level of functional dependency and limited life expectancy. The guidelines
suggest «clinicians should try to avoid symptoms of hyperglycemia and prevent hypoglycemia»
The European Union Geriatric CPG for type 2 diabetes mellitus has put numbers on glycemic targets for frail elderly
that could be used in your facility.
Summary of recommendations for Adults with Diabetes
CPG 2008¹
Frail elderly
(1) Canadian Diabetes Association 2008 clinical practice guidelines (2) European Union Geriatric Society 2004 There is more prompting for providers to have patients reach A1C goals which can improve care, quality of life andalso reduce costs. Although hemoglobin A1C provides the past three months average of blood glucose levels it mayhave some limitations in assessing the every day fluctuations of the glycemia. Fasting blood glucose (FBG) and the 2hours postprandial may be helpful in assessing the wellbeing of a resident with diabetes mellitus. Stay tune for moreinformation in next newsletter on recommendations of frequency of monitoring blood glucose, protocol to treathypoglycemia and sick day management.
Thursday November 10 2011 from 8 am to 3:15 pm: Be part of the Diabetes Care Day
What you need to know right now
Presented by the Diabetes Educator Network of Eastern Counties (DENEC) at the Ramada Inn.
For more information contact Linda Rodgers from Canadian Diabetes Association (CDA) at 613-938-7497
Newsletters can be retrieved from our website : www.medicalartspharmacy.ca

Source: http://www.medicalartspharmacy.ca/documents/SeptOct11NL.pdf