New Drug Approvals From 2010

Even though a number of drugs were approved for use in 2010, they are just now hitting pharmacy shelves (and it will likely be a little longer before doctors start to write for them and insurances start to cover them). Knowing as much as you can about these drugs, their storage and related information will ensure that you can help your pharmacist keep your patients safe. Click on the name of the drug for full prescribing information as provided by the manufacturer.

Drug Classes: Diuretics

Used to treat: Hypertension, Edema due to CHF*

Mechanism of Action: Varies by specific variety (see below)

Contraindications: May cause cross sensitivity with sulfonamide or thiazide allergy, chronic electrolyte depletion, low potassium may increase risk of digoxin toxicity,

FDA Update 5/29/2011

The FDA has approved a couple new drugs this week. You can expect more information on them when and if I get more. 

FDA Approves Edurant (rilpivirine) in combination with other anti-retrovirals to treat HIV

Rilpivirine has been shown to effectively decrease viral load when combined with peginterferon alpha and ribavirin. It is contraindicated in pregnancy (of patient or patient's sexual parter), previous adverse reaction, history of anemia. Common side effects are anemia (regular CBCs should be performed), birth defects (two non-hormonal contraceptive forms should be used), itching, nausea, tiredness, anal problems, and taste changes. It may cause interactions with a number of HMG CoA Reductase Inhibitors (-statins), as well as a few other medications. More information is available in the medication guide.

Drug Classes: Angiotensin II Receptor Blockers (ARBs)

Used to treat: Hypertension, Congestive Heart Failure (CHF)*

Mechanism of Action: Competes for angiotensin II binding sites in vascular smooth muscle

Contraindications: Pregnancy, breast feeding, limited effectiveness in black patients

Drug-Food Interactions: Anticoagulants and Vitamin K

Anticoagulants (blood thinners) have some of the narrowest therapeutic windows of all the drugs available on the market. With Coumadin (warfarin) available in 0.5-1mg increments, it's easy to see that the tiniest alteration in dose can cause problems with too much clotting or too much blood thinning.

Drug Classes: Angiotensin Converting Enzyme (ACE) Inhibitors

Used to treat: Hypertension, congestive heart failure (CHF)*, to prevent CHF after heart attack#

Mechanism of Action: Prevents conversion of angiotensin I to its active form, angiotensin II by interfering with renin

Contraindications: Pregnancy, breast feeding, should be taken 1 hour before meals

An Overview of the Cardiovascular System

Arguably one of the most important, yet complicated systems in the human body is the cardiovascular system. It is made up of the blood, blood vessels and due to the nature of blood flow, it is affected by every organ system in the body, mostly indirectly. The renal system (the kidneys and adrenal medulla) have a very direct influence over the heart and cardiovascular system, though.

Labeling Medications

Alright, let's talk about what needs to be on a label. There's the easy stuff: pharmacy name and all of that, but that's mostly the job of the pharmacist (or whoever is ordering the labels) since most of the time that is all preprinted. Don't worry... I'll cover that stuff, too. But my biggest concern right now is the part that you're in charge of. So really... What do you actually NEED to put on the label?

There are eight items required by federal law to appear on all prescription labels....Any guesses on what?

Drug-Food Interactions: The Fact and Fiction of Grapefruit Interactions

Grapefruit seems to be the buzz word now-a-days in the medical world. With evidence that it can cause serious drug-food interactions due to alterations in liver function, experts on both sides are eager to get information out about it. Citrus growers don't want people abandoning their product out of fears of a drug interaction and pharmacists, doctors and drug companies want the correct information out there so that medications are as safe an effective as possible. 

Drug Classes: Beta Blockers

Used to treat: Hypertension, Angina (selected drugs only*), Tachyarrhythmias, Migraine, Congestive Heart Failure (selected drugs only), Glaucoma (Ophthalmic Only)


Mechanism of Action: Competes with epinephrine and norepinephrine for beta adrenergic receptors (most common in vascular tissue) resulting in lowered heart rate and blood pressure.


Contraindications: Congestive heart failure (except carvedilol and metoprolol ER), Cimetidine decreases clearance and increases effects of beta blockers, use cautiously with MAOIs

Drug Classes: Calcium Channel Blockers

Used to treat: Hypertension, Angina (selected drugs only*), Coronary Artery Spasm (selected drugs only#)


Mechanism of Action: Blocks the entry of Calcium ions (Ca2+) into cardiac and vascular smooth muscle tissue, delaying contraction


Contraindications: Known sensitivity, concurrent use of medications for erectile dysfunction (unsafe drop in blood pressure), Digoxin (increased serum levels of digoxin, toxicity), NSAIDs (decreased effectiveness of Ca2+ channel blocker), Grapefruit juice may increase serum levels

A Couple of the Bigger Stories out of the FDA this Week

Here's a couple of the bigger stories out of the FDA this week.... and my personal commentary on one...

Class I Recall of Coumadin 5mg Tablets

Bristol-Meyers Squibb is recalling a single lot of brand name Coumadin (warfarin sodium) 5mg tablets because a tablet was found to be a higher potency than expected. Warfarin is a high alert drug, even small amounts can cause significant inhibition of clotting.

The Role of a Pharmacy Technician

I think the biggest, most important thing that a pharmacy tech needs to remember is the scope of their job. They are the right hand of the pharmacist. First and foremost they need to remember that they are a PART of a unit. They are important and a pharmacist's job would be significantly harder without them, but you should never get so cocky or foolish as to begin doing the job of a pharmacist. 

Getting Started

So like it says in the description, this is intended to be a blog for all the pharmacy techs out there that maybe don't keep up with their world as much as they should. Maybe it's laziness, or maybe they just don't know where to start.

If it's the former, I can't help them. I'm only one person and I can't force them to sit down and read this. If it's the latter, well... that's where I come in. No, this won't count toward your CE credits, but I'll help you figure out where to find some of them. Give you a heads up about new drugs, major recalls, and maybe every once in a while teach you a little about anatomy, pharmacology, pharmacokinetics, or just plain interesting facts and reminders about what we're supposed to be doing as pharmacy techs.

I welcome questions and comments of all sorts. And I promise I will try my hardest to get to any and all questions asked of me.

The goal is to update this three times a week, so keep me to it.

Until then,
C. Samuels