?  New Efforts to Prevent Medication Mix-ups.
?  Boehringer, Pfizer Respiratory Drug May Worsen Heart Problems

?  New Efforts to Prevent Medication Mix-ups
Every pharmacist dealing with dispensing and medication management would know too well about look alike, sound alike kind of drugs; eg. clonidine for high blood pressure can easily be mixed up with Klonopin for seizures, or colchicine for  gout..

Mixing up drug names because they look or sound alike is among the most common types of medical errors, and sometimes this seemingly small error can be deadly. Often, the root cause analysis must not stop at within the hospital or pharmacy levels. The root of the problem sometimes stems from the very birth place of the drug – ie. during the pre-commercialization phase of the drug. With that in mind, it’s often futile for pharmacists trying to stamp out problems like Xanax vs. Xatral; Celexa vs. Celebrex; Paxil vs. Plavix; chlorpheniramine vs. chlorpromazine vs. chlorpropamide etc. According to a major study conducted by US Pharmacopeia, nearly 1,500 commonly used drugs have names so similar to at least one other that mix-ups sometimes become so “inevitable”. Sounds like another day in a busy pharmacy; but we sure hope this doesn’t happen to someone we know or we love. 

Underpinning the significance of avoidance of mix-ups at the earliest possible stage, the US FDA  rejects more than a third of proposed names for new drugs because they're too similar to old ones. Increasingly, this responsibility will be shifted to manufacturers. The goal is to spell out how to better test for potential mix-ups before companies seek approval to sell their products.

Additionally, a web-based tool was set up last month to let consumers and doctors easily check if they're using or prescribing any of the error-prone drugs, and what they might confuse it with. Take a look at the drug error finder at www.usp.org/hqi/similarProducts/choosy.html and it's easy to see how mistakes can happen.

According to estimate, at least 1.5-million Americans are harmed each year from medication errors, and name mix-ups are blamed for a quarter of them.

Doctors' notoriously bad handwriting isn't the only culprit. A hurried pharmacist faced with alphabetized bottles on a shelf might grab the wrong one. Phone or fax a prescription, and static or smudged ink can turn epilepsy drug Lamictal into antifungal pill Lamisil. Electronic prescriptions which are now more common in our hospitals can reduce such incidents; but different types of errors due to pull down menu etc can indeed cause different problems.

?  Boehringer, Pfizer Respiratory Drug May Worsen Heart Problems
New evidence has emerged that anticholinergic inhalers for treatment of emphysema and chronic bronchitis may increase the risk of fatal heart complications

and stroke. Taking the hit from this study has been Spiriva and Atrovent from German pharma Boehringer Ingelheim.

Patients with COPD who took Spiriva or ipratropium  had a 58% higher risk of cardiac death, heart attacks or strokes than those on a placebo or other

treatments, according to research the JAMA. The findings were based on an analysis of clinical trials.  The study adds to findings that the drugs may be linked

to stroke and heart complications, prompting researchers to call for regulatory review of the products' safety.

A study published in earlier issue of Annals of Internal Medicine found that patients with COPD who used ipratropium had a 30% higher risk of dying from heart

complications than those who took sallbutamol. Those on the treatment also had an 11% increased risk of dying from any cause.

In March the US FDA said Spiriva may raise the risk of stroke, citing a pooled analysis of 13,500 patients.

In the 17 trials that they analysed, long-term use (more than 30 days) of the two anticholinergics ipratropium (Atrovent) and tiotropium (Spiriva) increased the

risk of a heart attack by 53% and the risk of cardiovascular death by 80%.

This would mean the drugs could cause one in 40 users to die from a heart condition and one in 174 to have a heart attack, say the researchers.

**********