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Importance of Folic acid in pregnancy to prevent neural tube defects (NTD)

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Next to cardiac abnormalities, neural tube defects are the second most common major congenital disorders. Spina bifida, a type of NTD, is the most common cause of congenital ambulatory disability.

Awareness about the importance of preventing NTD through sufficient folic acid intake during the periconception period has grown over the past 15 years.

Fortunately, the number of infants born with a NTD has declined. In 1997, 7.5 per 10,000 births in Canada were affected by a NTD (approximately 260 births/year), compared to 11.6 per 10,000 births in 1989. This decrease may be explained by an increase in folic acid supplementation and an improvement in prenatal diagnosis of NTDs, with possible pregnancy termination. Some studies also indicate that perinatal folic acid supplementation decreases the occurrence of defects of the heart, urinary tract, limbs, and possibly orofacial clefts.

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New Product Updates in Canada

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From April 2008 edition of a Canadian Pharmacists Journal (CPJ).

Cubicin (daptomycin for injection by Cubist Pharmaceuticals Inc. and distributed by Oryx Pharmaceuticals Inc.) is an antibacterial agent approved for the treatment of adults with 1. Complicated skin and skin structure infections (cSSSI) caused by susceptible strains of gram-positive microorganisms such as Staphylococcus aureus, S. Pyogenes and S. agalactiae and 2) bacteremia caused by S. aureus, including right-sided infective endocarditis affecting a native valve.

‘Cymbalta’ (duloxetine hydrochloride by eli Lilly Canada Inc.) is selective serotonin and norepinephrine reuptake inhibitor (SNRI) approved for the treatment of painful diabetic peripheral neurophathy.

‘Frova’ (frovatriptan succinate by TEVA Neuroscience) is for the acute treatment of migraine attacks with or without aura in aults.

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EFFECT OF DIRECT-TO-CONSUMER ADVERTISING IN U.S. / CANADA

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Article from ‘The Star’ news,

Canada’s ban on direct-to-consumer drug advertising probably saved Canadians with high cholesterol and their drug plans $150 million in 2006 alone.

A new study comparing U.S. and Canada sales patterns of a controversial cholesterol lowering drug show the dramatic savings.

Canadian sales of the drug Ezetrol (ezetimibe) were four times lower than those rung up south of the border, where the drug’s manufacturers spent $200 million (U.S) advertising the drug to consumers in 2007.

Sales of ezetimibe, which is sold in the U.S. as ‘Zetia’ or combined with a ‘statin’ drug as ‘Vytorin’ are expected to drop after releasing the trial results showing the drug failed to slow atherosclerosis, the clogging of the arteries with fatty deposits.

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The first new Pharmacy school in Canada after 20 years..

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University of Waterloo is creating a new school of Pharmacy in Downtown Kitchener. The School pf Pharmacy, which is the first new school in Canada in 20 years, will fill the urgent demand for more pharmacists in Ontario. This innovative project is the result of a unique partnership between the City if Kitchener and University of Waterloo.

The first undergraduate class of 120 students started in January 2008. This Baccalaureate in pharmacy program at the School of Pharmacy, has been granted qualifying accreditation Status by the “Canadian council for Accreditation of Pharmacy programs”
At full operation, the school is expected to have 480 undergrads, 70 graduate students, 30 faculty members, and 20 staff. Special feature is that this program is a co-op program: the first in Canada. All students will alternate work terms with academic study, taking their classroom experience to the workforce, and bringing work experience back to class.

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Colon Cancer Check, a new cancer screening program for all Ontarians

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In January, 2007, the Ontario government in collaboration with Cancer Care Ontario announced the launch of a new province-wide colorectal cancer screening program.

This program, first of its kind in Canada, will provide regular colorectal cancer screening to all asymptomatic Ontarians 50 years and older. The program goals are to reduce the mortality from colorectal cancer through an organized screening program and to improve the capacity for primary care to participate in comprehensive colorectal cancer screening. ColonCancerCheck will do this by expanding access to screening, supporting physicians and other health care professionals to screen patients, and educating the public about colorectal cancer screening.

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Azithromycin for Acne in Adolescents

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Acne vulgaris is a common inflammatory disorder of the pilo-sebaceous follicles. It is a multifactorial disease and its pathophysiology centers on the interplay of follicular hyperkeratinization, colonization with Propionibacterium acnes (PA), increased sebum production, and inflammation. This disease is occurring mainly in adolescence. Although the peak of prevalence is around the 17th year of life, acne lesions can appear earlier and are not uncommonly observed in the age group ranging from 12 to 14 years.

Antibiotic therapy has long been found useful in the management of moderate-to-severe acne vulgaris. Mechanisms of action include suppressing growth of PA, reducing the production of inflammatory mediators, and acting in immunomodulation. Commonly prescribed antibiotics include tetracyclines, doxycycline, minocycline and erythromycin.

Based on an article published in March edition of Medscape Journal:

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Change your life naturally………and LOOK good – Effect of vitamins on EYE - HEALTH

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VITAMIN C

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Regulations governing pharmacists impose high costs on consumers, says Competition Bureau of Canada..

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Competition Bureau of Canada says provincial colleges and boards of pharmacy in Canada should consider removing a number of restrictions that increase costs to consumers.

This article was published in one of the pharmacist’s journals recently. I don’t agree with this. Let me discuss briefly about this article.

Fee schedules, advertising restrictions, and admission requirements for foreign trained- pharmacists were among the regulatory issues the Competition Bureau flagged as potential barriers to healthy competition in the marketplace for pharmacists services.

Bureau says that, Fee schedules can potentially facilitate collusion in price settings, so it recommends removing Fee schedules in provinces where fee schedules for pharmacists exist.

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A NEW ANTIHYPERGLYCEMIC AGENT, JANUVIA, IN CANDIAN MARKET

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The first DPP-4 inhibitor, JANUVIA (Sitagliptin phosphate monohydrate), for patients with type 2 diabetes as add-on therapy to metformin had been introduced in Canadian market recently. JANUVIA inhitbits DPP-4, an enzyme which rapidly inactivates the harmones called ‘Incretins’ (Incretins are hormones produced in the intestines and whose levels rise in response to food. These hormones play a role in regulating insulin and glucagons secretion, and hepatic glucose production), thus increasing insulin release and decreasing glucagons levels in a glucose-dependent manner.

Januvia is used in combination with metformin in adult patients with type 2 diabetes to improve glycemic control whem diet and exercise, plus metformin do not provide adequate glycemic control. However, this medication should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis and not recommended for use in pregnant or nursing women.

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Pharmacist growth versus population in Canada, CIHI report:

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It was quite interesting to know about pharmacist’s database (PDB) in Canada. I was reading an article in one of the pharmaceutical journals, CPJ, and surprised to know about pharmacists growth versus Canadian population. Read this,

Total number of active pharmacists registered in Canada grew by almost 33% between 1995 and 2005 where as the Canadian population grew by only 10 % over that period, according to the Canadian Institute for Health Information (CIHI). There were 29,471 registered pharmacists in 2005, an increase of more than 7200 over the decade, says CIHI.

Higher pharmacist growth was seen in Prince Edward Island by 42.9% in comparison to other provinces in Canada. On the other hand, Northwest Territories showing 40.5% decline. Overall one third of pharmacists are in Ontario.

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