Antiemetic therapy in managed care oncology: roundtable discussion.

Few diagnoses are feared more by patients than cancer. In addition to the life-threatening nature of many cancers, the spectre of very difficult the treatment provides patients with little or no level of comfort. However, recent advances in the treatment of the side effects of cancer chemotherapy are helping to change these attitudes. On April 4, 1996, a panel of experts was convened to discuss these issues and how they affect MCOs.

Multisource drugs: implications and concerns in the geriatric population.

The demand for high-quality, cost-effective pharmaceuticals has increased. Much of this demand has evolved as a result of rising healthcare costs, state and federal entitlement programs, and third-party drug benefit restrictions. Patent expirations and changing patient demographics, as well as recent contributory forces, have fueled the need for multisource drugs and led to their greater availability. Legislative attention focused on the Food and Drug Administration and Abbreviated New Drug Application approval has had a positive effect on the multisource industry. The public is assured an era of vigilance, continual quality assessment, and greater integrity in the multisource drug approval process. The elderly are a rapidly growing population of prescription drug users who can benefit from cost-effective pharmaceuticals, such as those offered by multisource drugs. However, concerns and issues have arisen regarding the use of multisource drugs in the elderly. This article reviews these concerns and places into perspective the role of multisource pharmaceuticals in this population.

Individualized assessment of the older patient.

The increase in the elderly population has influenced health care policy and economics to the point where even drug therapy for this group must be re-examined. Important drug use issues in the elderly include inadequately defined goals, multiple illnesses/multiple drugs, adverse reactions, pharmacokinetics/pharmacodynamics, compliance, and self-care. Specific strategies for dealing with each of these issues are acceptability/suitability of specific drugs, formalized compliance analysis, cooperative monitoring and profiling, effective patient communication, and patient education.

Antacids and laxatives for symptomatic relief in the elderly.

Guidelines for the safe, effective use of antacids and laxatives are presented, with emphasis on the special problems and considerations of their use in the elderly. Discussed are properties affecting drug selection, dosage, measures to ensure compliance, adverse reactions, and drug interactions. Physician--patient dialogs are recommended, as is patient education about the dangers of inappropriate or excessive use of these products, and the need to obtain medical care for unremitting symptoms.

Complications of alcohol use combined with drug therapy in the elderly.

Chronic ingestion of ethanol in alcoholic beverages can impair drug therapy, lead to sometimes hazardous interactions, or compromise adherence to a well-planned drug treatment program. Various drugs consistently interact with alcohol: CNS depressants, such as benzodiazepines, barbiturates, muscle relaxants, antihistamines, and psychotropic agents; analgesics, including aspirin and narcotics; anticoagulants and other cardiovascular drugs, namely digitalis glycosides, diuretics, antihypertensives, and antiarrhythmics; and antidiabetic agents. Abstinence from alcohol by elderly patients receiving these drugs is recommended.

Preceptors' views of community pharmacy clerkships: a national survey.

A survey was administered to a random sample of community pharmacy practitioners who participate as preceptors in clerkship programs for colleges of pharmacy throughout the country. The purpose of this survey was to determine (1) in what ways, if any, students have affected the preceptors' practices; (20 whether the students served as a sources of continuing education to the preceptors; (3) whether the preceptors identified areas of students' strengths/deficiencies; and (4) roles of colleges of pharmacy and pharmacy associations in providing continuing education programs for pharmacists. Results of this survey are discussed. Data are cross-tabulated for types of pharmacy services provided, years in practice, length of clerkship rotations, and other essential demographic information needed for evaluation. Based on responses, recommendations are made that will provide guidance to colleges of pharmacy, pharmaceutical associations, and practitioners currently involved or those who are considering involvement in clerkship programs.