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Las Vegas, NV Nevada Attorney General George Chanos announced today that the Attorney General's Senior Medicare Fraud Patrol SMFP ; program has received a three year grant totaling 0, 000 from the United States Administration on Aging. The money will be used to fund the SMFP and train retired professional volunteers to help their peers become better health care consumers. The volunteers work to educate older Nevadans about the importance of reviewing their Medicare notices to identify billing errors as well as potentially fraudulent activity. Program volunteers also encourage seniors to report discrepancies to the SMFP project, so that the project may ensure appropriate resolution or referral. "Nevada's seniors benefit the most from the Senior Medicare Fraud Patrol project and the Nevada Attorney General's Office is grateful for the financial support it receives from the Administration on Aging, " Attorney General Chanos said. "These funds will allow us to provide services to our seniors that promote understanding of Medicare and Medicaid program benefits." Administration on Aging provides grants to states, territories, other jurisdictions and community-based non-profit organizations. Each project is designed to focus on providing program services to seniors who are homebound, rural, nonEnglish speaking or otherwise underserved. The SMFP is part of the Attorney General's Senior Protection Unit which works to educate and protect seniors and to prosecute those who take advantage of Nevada's seniors. For more information on the Senior Medicare Patrol program, please visit the AoA web site at : aoa.gov smp. More information on the Nevada Attorney General's Senior Protection Unit can be found at ag ate.nv.
The following is a list of the most commonly prescribed drugs. It represents an abbreviated version of the drug list formulary ; that is at the core of your pharmacy benefit plan. The list is not all-inclusive and does not guarantee coverage. In addition to using this list, you are encouraged to ask your doctor to prescribe generic drugs whenever appropriate. Over-the-counter medications are not covered under the pharmacy benefit. The following is a list of some non-formulary brand medications with examples of selected alternatives that are on the formulary. Thank you for your compliance. Non-Formulary Accuretic Aceon Aciphex Activella Aerobid M Allegra, D Alphagan P Altocor Atacand Atacand HCT Avalide Avapro Avinza Axert Azelex Benicar Benicar HCT Cardene SR Cardizem CD Catapres-TTS Ceclor Cedax Cenestin Clarinex Colazal Covera- HS Crestor Dipentum Dynabac Dynacirc CR Estraderm Focalin Frova QL ; Glyset Helidac Kadian Lamisil topical Lescol, XL Lorabid Lumigan Mavik Maxalt, MLT QL ; Maxaquin Metadate CD, ER Micardis Micardis HCT Monopril HCT Nasarel Nasonex Formulary Alternative enalapril hctz, lisinopril HCTZ, Lotensin HCT G ; captopril, enalapril, lisinopril, Altace, Lotensin G ; omeprazole 10mg ; QL ; , Nexium PAR ; QL ; , Protonix PAR ; , Prilosec OTC FemHRT, Prempro Premphase Azmacort QL ; , Beclovent QL ; , Flovent QL ; OTC Alavert, OTC Claritin, OTC loratadine brimonidine tartrate lovastatin, Lipitor, Pravachol Cozaar, Diovan Diovan HCT, Hyzaar Diovan HCT, Hyzaar Cozaar, Diovan Generics, MS Contin Amerge QL ; , Imitrex QL ; , Zomig ZMT QL ; Generics, Differin PAR ; Cozaar, Diovan Diovan HCT, Hyzaar nifedipine extended release, Norvasc diltiazem extended release clonidine hcl cefaclor extended release amox tr potassium clavulanate, Augmentin ES XR, Premarin OTC Alavert, OTC Claritin, OTC loratadine Asacol, Pentasa, Rowasa verapamil extended release lovastatin, Pravachol, Lipitor, Zocor Asacol, Pentasa, Rowasa erythromycin, Biaxin XL, Zithromax nifedipine extended release, Norvasc Generics, Climara methylphenidate, Concerta Amerge QL ; , Imitrex QL ; , Zomig ZMT QL ; Precose Prevpac Generics, MS Contin OTC Lamisil Lipitor, lovastatin, Pravachol amox tr potassium clavulanate, augmentin ES XR, Travatan, Xalatan captopril, enalapril, lisinopril, Altace, Lotensin G ; Amerge QL ; , Imitrex QL ; , Zomig ZMT QL ; Avelox, ciprofloxacin, ofloxacin, Levaquin methylphenidate Cozaar, Diovan Diovan HCT, Hyzaar enaplapril hcyz, lisinopril hctz, Lotensin HCT Flonase QL ; , Beconase AQ QL ; Beconase AQ QL ; , Flonase QL ; Non-Formulary Optivar Oxytrol Penetrex Pravigard Prevacid QL ; PAR ; Protopic Prozac Weekly QL ; Pulmicort excluding respules ; QL ; Quixin Qvar Relenza Relpax Rescula Restoril 7.5MG Rhinocort AQ Risperdal M-Tab Ritalin, LA Serzone Skelid Sonata QL ; Spectracef Sular Suprax Tarka Tequin Testoderm Testim Teveten Teveten HCT Uniretic Vancenase AQ QL ; Vantin Ventolin QL ; Vexol Vivelle-Dot Zagam Zyflo Zyprexa Zydis Zyrtec Formulary Alternative Patanol, Zaditor Detrol LA PAR ; Avelox, ciprofloxacin, ofloxacin, Levaquin lovastatin, Lipitor, Pravachol Omeprazole 10mg ; QL ; , Nexium PAR ; QL ; , Protonix, Prilosec OTC Elidel fluoxetine daily ; , Celexa 10mg and 40mg ; , Lexapro PAR ; , paroxetine, Paxil CR PAR ; , Zoloft 25mg and 100mg ; Azmacort, Beclovent, Flovent QL ; Ciloxan, Vigamox Azmacort QL ; , Beclovent QL ; , Flovent QL ; rimantadine Amerge QL ; , Imitrex QL ; , Zomig ZMT QL ; Travatan, Xalatan temazepam Flonase QL ; , Beconase AQ QL ; Risperdal non M-tabs ; methylphenidate, Concerta, Strattera non-stimulant ; bupropion, Effexor xr, mirtazapine, Wellbutrin SR PAR ; Actonel, Didronel, Evista, Fosamax Ambien QL ; amox tr potassium clavulanate, Augmentin ES, Omnicef nifedipine extended release, Norvasc amox tr potassium clavulanate, Augmentin ES XR, Omnicef verapamil + ACE inhibitor, Lotrel Avelox, ciprofloxacin, ofloxacin, Levaquin Androderm, Androgel Androderm, Androgel Cozaar, Diovan Diovan HCT, Hyzaar enalapril hctz, lisinopril hctz, Lotensin HCT Beconase AQ QL ; , Flonase QL ; amox tr potassium clavulanate, Augmentin ES XR, Omnicef albuterol inh QL ; , Maxair Auto QL ; , Proventil HFA QL ; Generic steroids, Lotemax Generics, Climara Avelox, ciprofloxacin, ofloxacin, Levaquin Singulair PAR ; Zyprexa non-Zydis ; OTC Alavert, OTC Claritin, OTC loratadine.
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Council met in Moose Jaw on Friday May 2, 2003, prior to the opening of the RBSP 2nd Annual Conference. As the mandate of the SPhA is protection of the public, it is imperative that we communicate with the public to determine what are their needs, and expectations of the profession. Within the policy GP-11 Council Linkage with Ownership, one aspect is "Collection of input from the community may be accomplished through a variety of methods, including, but not limited to, public meetings, surveys and focus groups." In an attempt to reach members of the public, an advertisement was published in the Moose Jaw Times Herald inviting members of the public to attend a round table discussion with Council on the question "How can your pharmacists help you manage your medications better?" Unfortunately, we were unable to attract the public's attention. This has not deterred Council, who will look at other means of seeking information from the ownership. Vice-Chief Lawrence Joseph of the Federation of Saskatchewan Indian Nations whose portfolio is Health and Social Development met with Council to discuss mutual issues of interest regarding how can we work together to achieve healthy outcomes from drug therapy for First Nations peoples. Naturally the NIHB Consent Initiative was discussed, and the implications of implementation. When asked what the profession can do to meet the health needs of First Nations people Vice Chief Joseph suggested that we be accessible to the community, go on the reserves, get to know the people and let them know you. Offer advice or guidance whether to the individual patient or speak to the health directors and health staff at the band level. They want to work with the profession to improve health outcomes for their residents. During the last Council meeting, representatives from the Health Quality Council presented their vision of the future. At the end of the presentation they had invited Council to submit ideas and priorities to assist in setting the Health Quality Council Agenda. Council responded by identifying the following topics that the Quality Council be asked to add to their agenda: 1. Blame Free for Error Reporting a process to focus on causes and solutions to systems errors without assigning blame to an individual 2. Best Practices promoting the most effective practises 3. Integrated Drug Use Management System promoting strategies to coordinate drug use management initiatives to achieve similar outcomes 4. Seamless Care improving the quality of information shared within the system 5. Primary Health Care examining professional scopes of practice and roles to optimize delivery Council held their election of officers during the meeting. For the 2003-2004 licence year the following is the SPhA Executive: President Randy Wiser Division 3 Past President Brenda Schuster Division 8 President-Elect Bill Paterson Division 5 Vice-President Debbie McCulloch Division 7 There remains one vacancy on Council, that for Division 2. As this seat has been vacant for one year and the call for nominees was unsuccessful Council felt that other measures must be considered. Council approved an administrative bylaw which became effective on May 2, 2003 to address this issue. Please refer to page 3 in this publication. Other appointments made during the meeting are: Janet Bradshaw was re-appointed to a one year term on the NAPRA Council. With Janet's retirement from the SPhA Council, in accordance with the Act, she could no longer sit as Chair of the Complaints Committee. Council appointed Bill Paterson Chair of the Committee; his term began July 1, 2003 and garlic.
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Extremity pain and swelling after being treated for bronchitis with levofloxacin in her prior visit. On examination, the calf and dorsum of the left foot was associated with moderate swelling and ecchymosis around the insertion of Achilles tendon. Full range of motion at the ankle was limited due to pain. The pulses were intact. A MRI was performed since a tendon rupture was suspected due to the acute nature of presentation and a history of fluroquinolone use. The MRI showed a near full thickness of the Achilles tendon around 3 cm proximal to the calcaneal insertion. Patient chose the non surgical approach and was treated by non weight bearing cast. Case report #2: This is a 72 year old male who presented to the clinic with ecchymosis of right lower extremity and intense edema. He was treated with Gatifloxacin 10 days prior to this presentation for COPD exacerbation. Deep vein thrombosis was ruled out by Doppler U S of the Lower Extremity. Further investigation by MRI showed rupture of the right Sartorius tendon at the insertion to knee. This is the first case to be reported for Gatifloxacin induced tendon rupture. He was treated initially by phonopheresis and continued conservative non surgical management since he was not a surgical candidate. Conclusion: FQ induced myotendinopathy has been reported extensively in the literature since the 80's, due to the concern associated with the widespread use of antibiotics in modern medicine. It has been associated with numerous risk factors of which concurrent steroid use and age 60 play a very important role. The exact mechanism by which it occurs is still unclear. There has been data showing an ischemic vascular insult predisposing the rupture. Also, Quinolones upregulate the expression of Matrix metalloproteinases which are involved in the rapid turn over of the cells thereby causing tendon injury. A thorough physical exam and history is helpful in the diagnosis of most cases. MRI is a sensitive and a specific tool to assess the severity of rupture. Management can be either conservative or involve an aggressive surgical approach based on the age, comorbidities and life style of the patient.
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Important new information on side-effects associated with the use of Bextra, a COX-2 selective nonsteroidal anti-inflammatory drug that is indicated for the treatment of osteoarthritis, rheumatoid arthritis, and dysmenorrhea was reported in December 2004 by the US FDA. A "boxed" warning will be added to the label, stating that patients taking Bextra have reported serious, potentially fatal skin reactions, including Stevens-Johnson Syndrome and toxic epiderma necrolysis. These skin reactions are most likely to occur in the first 2 weeks of treatment, but can occur at any time during therapy. In a few cases, these reactions have resulted in death. The labeling advises doctors that Bextra should be discontinued at the first appearance of a skin rash, mucosal lesions, or any other sign of allergic reactions. The warning also states that Bextra contains sulfa, and patients with a history of allergic reactions to sulfa may be at a greater risk of skin reactions. The US FDA announced in November 2004, that the risk minimization actions plan RiskMAP ; for Accutane isotretinoin ; and its generic equivalents is being enhanced in order to reduce the risk of birth defects associated with fetal exposure to isotretinoin. Under the new program, sponsors will obtain registration of not only prescribers, but also pharmacies that dispense and patients who use isotretinoin. The program also includes documentation of a negative preganancy test before giving isotretinoin to women who are capable of becoming pregnant. The registration system will be built to incorporate physician and patient identification codes that will also protect the privacy of the patients. The innovator and generic sponsors of isotretinoin have jointly contracted with Covance, Inc. to design, build, implement and operate a single strengthened isotretinoin RiskMAP incorporating these elements and gemcitabine.
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