This session could also be known as: a whirlwind journey through 2010 pharmacology with Mary Lynn McPherson, Pharm.D., BCPS, CPE from the University of MD. She is a very entertaining and engaging speaker, also very quick! She reviewed the FDA decision to remove propoxyphene from the market, which has been highlighted in other blogs as well. She discussed the FDA concerns and restrictions regarding acetominophen in common opiod formulations. In addition, I didn’t know there was an official definition of opiod tolerance – any one of the below:
- 60 mg oral morphine per day
- 25 mcg TDF every three days
- 30 mg oral oxycodone per day
- 8 mg oral hydromorphone per day
- 25 mg oral oxymorphone per day
Several highlights to remember:
- Many new and very expensive drugs on the market taking advantage of alternative delivery systems
- Nuedexta (dextromethorphan/Quinidine) for uncontrolled laughing/crying in neurological diseases. Helpful but over $600/month
- Abstral (SL Fentanyl) available. Extensive REMS (Risk Evaluation and Mitigation Strategies – FDA) which will include special certification for providers as well as pharmacies.
- Exalgo – a once daily hydromorphone formulation
- BuTrans – transdermal buprenorphine which can be worn for 7 days for pain relief
- OxyContin reformulation – designed to prevent abuse, many patients feel it isn’t as effective.
- Duloxetine (Cymbalta) – indication for chronic musculoskeletal pain (low back pain, etc)
- Acetaminophen IV (Ofirmev) available – long awaited by many (including me!). Will be over $10 per dose, compared to pennies for other routes of administration. Will still be huge blockbuster!
- Cryostat – a very effective cold pack for hemorrhoid relief
Overall, LOTS of information in a great presentation. I was only sorry it was at the end of the day (I feel much sharper earlier in the day!).
Would be curious if anyone else picked up other tips that might be helpful – please share in comments.