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e-Pharmalink - September 2007e-Pharmalink is the e-mail newsletter of the Ecumenical Pharmaceutical Network (EPN) an independent, apolitical, non-profit Christian organization. This newsletter aims to alert pharmacists and other health professionals of information sources about international trends relevant to their work and opportunities that could support them in their efforts to provide effective and efficient services, particularly in poorer countries. It summarizes information reported by a wide range of publications or organizations and includes web links to the original sources. Anyone can receive this e-mail. If you have any information to contribute or comments on the content, or if you would like to unsubscribe, subscribe or recommend someone to receive it, please contact Info@epnetwork.org. This edition includes: News Focus on Resources Drug induced pancreatitis Medicines are estimated to account for about 2 to 5% of pancreatitis cases. Reports of pancreatitis are most frequent with azathioprine, didanosine and valproate. The drug groups more commonly implicated include antiviral agents, hypolipidaemic agents, atypical antipsychotic medicines, corticosteroids and other immunosuppressants. http://www.tga.gov.au/adr/aadrb/aadr0612.pdf
Tenofovir provides an effective long-term treatment for hepatitis B in HIV-positive patients Tenofovir (Viread) provides an effective long-term treatment for hepatitis B as a component of antiretroviral therapy in HIV-positive individuals. According to two studies conducted in London and Duesseldorf and presented at the Third International Workshop on HIV and Hepatitis co-infection, tenofovir also provides a potent anti-hepatitis B therapy even in patients who have 3TC (lamivudine, Epivir) resistant hepatitis B.
Link between diabetes and antiretrovirals may particularly affect resource-poor settings A Swiss study published in the journal of Clinical Infectious Diseases has found that some HIV drugs, particularly protease inhibitors (PIs), often used in resource-poor settings, may increase the risk of acquiring diabetes.
HIV/HBV co-infected patients should not take entecavir unless on anti-HIV treatment due to resistance risk The anti-hepatitis B drug entecavir (Baraclude) should not be prescribed to HIV-positive individuals unless they are taking potent anti-HIV therapy. Maker of the drug, Bristol-Myers Squibb (BMS) are warning that the use of entecavir by HIV-infected individuals who are not taking antiretroviral therapy could lead to the development of stains of HIV with resistance to drugs from the nucleoside reverse transcriptase inhibitor (NRTI) class.
Moxifloxacin as effective as ethambutol in TB treatment Moxifloxacin has proved just as effective as ethambutol as part of a four-drug induction regimen for TB treatment. Moxifloxacin is of particular interest in the treatment of TB in HIV-positive people because it has no interactions with antiretrovirals and may be potent enough to shorten the duration of TB treatment, which currently stands at a minimum of six months. The drug is an antibiotic already licensed in over 100 countries with a well-understood side-effect profile. http://www.aidsmap.com/en/news/7DC7F2B9-CE26-4DA0-BF15-CF89E77B52AF.asp
WHO treatment guidelines may need revising According to a study conducted in Peru and published in an on-line January 2007 version of the Journal of Infectious Diseases, the World Health Organisation’s (WHO) 1991 guidelines for the management of persistent diarrhoea in HIV-positive patients in resource limited countries may need revising in some settings. Current WHO guidelines recommend co-trimoxazole prophylaxis for persistent diarrhoea in HIV-positive patients. However, the study found that only 24% of the pathogens causing diarrhoea were susceptible to co-trimoxazole, but that ciprofloxacin, doxycycline and erythromycin were all widely effective.
Malaria over-diagnosis and over-treatment in Zambia According to the findings of a cross-sectional survey published in the May 2007 edition of the Journal of American Medical Association, malaria diagnostics in Zambia are grossly underused and there is widespread over-treatment for malaria in patients with negative test results. The study calls for the provision of new tools to reduce the overuse of expensive antimalarial treatments and recommends a major change in the treatment of fever in patients without malaria.
New Malaria vaccine is shown to work in infants under 1 year old A new study published in the October 2007 edition of The Lancet indicates that the world’s most promising malaria vaccine has been shown to work in infants less than a year old - the most vulnerable group. Though containing a small study group (214 babies) the study also indicated that the risk of catching malaria was reduced by 65 percent after the full course of three shots.
Co-artemether and lumefantrine highly effective in malaria prone areas According to results of two randomized controlled studies published in The Lancet a six-dose course of the combination of two drugs - artemether and lumefantrine (coartum or Riamet) - is a highly effective treatment for malaria in the resource-limited settings where resistance to frequently used malaria drugs is common. A Tanzanian study reported that the combination was superior to several other commonly used treatments. The other study, conducted in Uganda, found that adherence to the combination’s complex dosing regimen, although perhaps not perfect, was good enough for use in a resource-poor setting to remain highly effective.
This is a new open-access online journal featuring high-quality peer-reviewed online journals on Neglected Tropical Diseases. The site hosted by PLoS, the Public Library of Science (http://www.plos.org). All PLoS articles are freely available online for use, and the copyright remains with the author. http://www.healthnet.org/essential-links/ This resource provides more than 600 useful websites for health professionals, medical library communities, publishers, and NGOs in developing and emerging countries.
Coincidence or crisis: book on pharmaceutical counterfeiting This book highlights the growth of counterfeit pharmaceuticals. It provides a comprehensive analysis of the core issues, while delimiting key strategies to tackle the problem.
Quality Assurance of Pharmaceuticals (Second Updated Edition) This is a compendium of guidelines and related materials covering all aspects of Good Manufacturing Practices and Inspection. It is a reliable resource for those working in faculties of pharmacy, in medicines regulation and control, and in the pharmaceutical industry. http://www.who.int/bookorders/anglais/
Global price reporting mechanism on antiretroviral drugs – July 2007 This is a report comparing transaction prices paid in the first six months of 2007 for antiretroviral drugs by low and middle-income countries to the ones paid in previous years. http://www.who.int/hiv/amds/GPRMsummaryJuly2007.pdf
Course: Anti-retroviral and Related Drug Supply Chain Management in Low-resource settings Course: Promoting Rational Use of Medicine in the Community Course: Health District Management: Priority Setting and Resource Allocation For more details please visit: http://www.sti.ch or email courses-sti@unibas.ch END ( categories: e-Pharmalink )
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