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What's in the news:
Darvon or Propoxyphene has been associated
with 2,110 reported accidental deaths in the United States since 1981.
A large proportion of these deaths occur because most of the drug is
converted into a metabolite that is highly toxic to the heart and lasts
longer in the body than the original compound, resulting in cardiac
depression. Adverse cardiac events associated with propoxyphene include
an interruption of heart transmission of electrical impulses, slowed
heartbeats and a decreased ability of the heart to contract properly.
Fatalities within the first hour of overdosage
are not uncommon. In a survey of deaths due to overdosage conducted
in 1975, in approximately 20% of the fatal cases, death occurred within
the first hour (5% occurred within 15 minutes).
Because toxicity develops with the drug at only
slightly above the recommended daily dose, propoxyphene is consistently
mentioned as one of the top ten drugs found in peoples' systems during
autopsies.
The Journal of the American Medical Association,
published a study over 36 years ago in which they found that Darvon
or Propoxyphene was no more effective that two aspirin tablets.
Allvoices.com: November 2010
http://www.allvoices.com/contributed-news/7388869-fda-issues-darvon-and-darvocet-recall-due-to-risk-of-heart-problems
On January 13, 2011 The U.S. Food and Drug Administration (FDA) is asking drug manufacturers to limit the strength of acetaminophen in prescription drug products to 325 mg per dosage unit, making these products safer for patients. These products are mostly combinations of acetaminophen and opioids. This action will help to reduce the risk of severe liver injury associated with acetaminophen. OTC products containing acetaminophen are not affected by this action. The elimination of higher-dose prescription combination acetaminophen products will be phased in over three years and should not create a shortage of pain medication. Patients and health care professionals are being notified of the new limitation on acetaminophen content, and of the labeling change.
Chronicfatigue.about.com: January 2011
http://chronicfatigue.about.com/b/2011/01/19/fda-limits-ingredient-in-popular-fibromyalgia-painkillers.htm
Product
Alerts:
Over 1.3 million adults are dependent on prescription narcotics or heroin. Vivitrol, a long-acting injectable form of naltrexone, helps patients stay off opioids after detox. It is a replacement for methadone or buprenorphine (Suboxone). It is a once a month injection that works by blocking the effects of opioids should the person tries to use again. Patients must be off of opioids for at least 7 to 10 days and normal does of opioids cannot be used to treat pain when the patient is on Vivitrol. For acute pain, non-opioid analgesics such as NSAIDS, acetaminophen or regional anesthesia can be used. Although it does not require special training or accreditation to prescribe it, the cost is about $1100 per month.
Pharmacist's Letter: December 2010
http://pharmacistsletter.therapeuticresearch.com
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