The current gold standard for treatment of HCV is pegylated IFN alfa-2b combined with ribavirin generic for 48 weeks, depending on the genotype. However, more than 50% of patients do not respond completely to combination therapy, suggesting the need for more treatment options, such as ribavirin. The manufacturer recommends that patients weighing 75 kg or less receive 1,000 mg/day of ribavirin and that patients weighing 75 kg or more receive 1,200 mg/day.

…Read the rest of this article

Although great strides have been made in the treatment of chronic HCV infection since the discovery of the virus in 1989, therapy remains problematic. Most patients with chronic infection (defined by the detection of HCV RNA for at least six months)⁴⁵ have few signs and symptoms of disease. Infrequent signs and symptoms include fatigue, right upper-quadrant pain, nausea, and poor appetite. Selecting patients for treatment would be simpler if the current therapy (1) were less complicated, (2) carried high rates of sustained responses, (3) were simple to administer, (4) were required for a shorter time period, and (5) were easy to tolerate.

…Read the rest of this article

First identified in 1988, HCV infection is caused by a small, single-stranded RNA virus that is a member of the genus Hepacivirus and the family Flaviviridae. HCV replicates in the cytoplasm of hepatocytes and B lymphocytes. Persistent infection or a lack of viral clearance is related to continuous virus production and to the loss of helper T-cells. Genetic analysis reveals the existence of numerous subtypes, or genotypes. HCV has at least six major genotypes (1-6), which are found in clusters around the world, and 50 subtypes (i.e., 1a, 1b)

…Read the rest of this article

Introduction

Identified more than a decade ago, hepatitis С virus (HCV) is the leading cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC) and is the primary indication for liver transplantation in the U.S. This common chronic blood-borne infection affects approximately 3.8 million people in the U.S., with more than 50% of these cases occurring in adults between the ages of 30 and 49. However, the peak prevalence of chronic HCV is in the fourth and fifth decades of life (Figure 1). Although the infection resolves in 15% of patients, it becomes chronic in 85% of those infected. This article reviews the overall impact of HCV infection on society and health care.

…Read the rest of this article

Coronary heart disease is the single largest killer of people living in the U.S. Some of the risk factors include hypertension, obesity, smoking, and dyslipidemia, an irregularity of a patient’s lipid profile. Dyslipidemia covers a variety of disorders relating to abnormal levels of total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglycerides. The incidence of lipid metabolism disorders in hospitalized patients has risen steadily since 1997 and has more than doubled over the past six years (Figure 1).

…Read the rest of this article

Problem: A pharmacist is working alone in a busy hospital pharmacy. He receives a stat order for oral clonidine (e.g., Catapres®, Boehringer Ingelheim) 1 mg and levodopa (e.g., Laradopa®, Roche) 125 mg for a growth hormone stimulation test to be performed on an eight-year-old child. Despite significant pressure from the order and a backlog of work, the pharmacist, who is unfamiliar with the test, takes time to do some research on the topic and discovers that the correct test dose of clonidine for a pediatric patient is 0.15 mg/m². After he calls the physician, the order is changed to clonidine 0.1 mg.

…Read the rest of this article

Hold on to your hats! The new Medicare-approved Drug Discount Cards that are scheduled to become available in June 2004 will not only entitle Medicare beneficiaries to lower drug prices but will also send the drug industry on a wild ride over the next 18 months.

…Read the rest of this article