With the prescription drug benefit, members have access to medications that are on the Southern Health Prescription Drug List. A Prescription Drug List also called a Formulary ; is a list of approved medications covered by Southern Health. The Prescription Drug List includes an extensive list of both brand name and generic medications. The 2007 Prescription Drug List, a list of preferred drug alternatives, a list of drugs with mail order exclusions, and a list of drugs with quantity limits are on the following pages.
Sophie Jamal, MD, FRCPC Osteoporosis Research Program "I've always been interested in a career in academic medicine, and as part of that I've been interested in research. I did six months in a lab and found that it just wasn't for me, but I was still very, very interested in clinical trials and in patient care. I think the exciting thing about clinical research is that you see the patient and you can say to yourself, `I have this patient, she doesn't want to take hormones, she can't tolerate the other drugs that are out there, I have other options a research study.' The interaction with patients is what makes clinical research very different from basic science research. And that's what I really like about it, it has a direct applicability, it's not hard to see how you could use it in your practice in the next two or three years. When you see patients you always have questions, and it's a real luxury and a real privilege to be able to examine the questions in a scientific manner." An endocrinologist and member of the Osteoporosis Research Program, Dr. Jamal is supported by a Medical Research Council of Canada Clinician Scientist Award. She is interested in what causes osteoporosis. The traditional thinking is that, for instance, isosorbid.
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SLE is an autoimmune disorder which develops when the body's own immune system, which normally protects against cancers and invading infections, begins to attack the patient's own tissues known medically as a "loss of self-tolerance" ; . This occurs first through the production of "auto-antibodies" antibodies are immune system cells that attack foreign microbes; autoantibodies attack a person's own cells ; . As the attack continues, other immune system cells join the fight. This leads to inflammation, blood vessel abnormalities vasculitis ; and deposition of immune system cells in organs which causes tissue damage. It is not known why this inflammatory reaction begins, but it probably occurs because of some combination of inborn or hereditary predispositions and environmental factors such as viruses, the ultraviolet rays in sunlight, Silica dust, and allergies to medications ; . Recent research suggests that people affected by lupus may have a defect in the normal biological process of clearing old and damaged cells from the body, which then causes an abnormal stimulation of the immune system.
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Rogrammable implantable insulin pumps have proven to be safe and effective for achieving good metabolic control 1 ; and decreasing the rate of severe hypoglycemia 2 ; . In 1994, a change in the production of insulin resulted in insulin precipitation and recurrent events of underdelivery in the MIP 2001 models Minimed, Sylmar, CA ; . A new insulin variant with improved stability in delivery systems was produced in 1997 by Hoechst Marion Roussel and evaluated by the Evaluation dans le Diabete du Traitement par Implants Actifs EVADIAC ; Study Group 3 ; . Yet, persistent underdelivery was still observed and could not be resolved by flushing procedures through the side port catheter. Difficulties in adjusting insulin dosage remained problematic. This underdelivery was explained by the fact that the forward stroke of the piston pump occurred in 2 ms with a volume of 0.5 l, and the catheter lumen was only 0.2 mm in diameter. Thus, its compliance was too low to pass the stroke volume in 2 ms. Therefore, the manufacturer modified the catheter side port with the addition of three small titanium pillows that act as an accumulator, storing the initial impact of the hydraulic force pression of the stroke and adding compliance to the catheter system, resulting in an improved insulin delivery during bench tests. The EVADIAC Group designed a study protocol to investigate the effect of this new side port catheter on the stability of insulin delivery and to assess the clinical improvement of the catheter compliance. After the approval of an ethical committee, 40 type 1 diabetic patients, currently implanted, were consecutively enrolled for a new implantation with the Minimed implantable pump MMT 2001 and the modified side port catheter MMT 4027 Minimed ; . The patients were seen every 45 days to refill the pump reservoirs, to examine the accuracy of the insulin delivVOLUME.
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Over the past several newsletters, the Association has advised members about the importance of knowing their responsibilities under the new personal information protection act, PIPEDA. This federal act will be in effect as of January 1, 2004 and involves personal information, not just personal health information as it is defined under the provincial Personal Health Information Act PHIA ; . Both the Canadian Pharmacists Association and the Canadian Association of Chain Drug Stores have developed information packages "tool kits" ; to help pharmacy owners and managers to be compliant with the requirements under the act. All member pharmacists are encouraged to contact these organizations and non-member pharmacists can get further information through the Federal Privacy Commissioner of Canada website at privcom.gc and click on "privacy legislation, for instance, .
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Preeclampsia refers to new- onset hypertension systolic blood pressure [BP] 140 mm Hg or diastolic BP 90 mm and proteinuria after 20 weeks gestation in a previously normotensive woman. It affects 5%-8% of pregnancies and is the second leading cause of maternal mortality 12%-18% ; in North America. It is often accompanied by other signs of maternal end-organ damage, including oliguria, pulmonary edema, abdominal pain, liver dysfunction, thrombocytopenia, as well as visual and cerebral abnormalities.15 Eclampsia, characterized by the development of generalized tonic-clonic seizures in the setting of preeclampsia, occurs in up to 2% women with preeclampsia. Eclampsia is an obstetrical emergency because both mother and fetus are at immediate risk of death or longterm neurologic complications. Prompt delivery of the fetus and placenta is the only cure. Symptoms usually resolve after delivery. Visual symptoms in preeclampsia and eclampsia include decreased vision, photopsia, and visual field defects. The 3 most common visual complications of preeclampsia and eclampsia are hypertensive retinopathy, exudative retinal detachment, and cortical blindness. Possible explanations for these complications include coexisting or preexisting systemic vascular disease, changes in hormonal milieu, endothelial damage, abnormal autoregulation, hypoperfusion ischemia, or hyperperfusion edema. Each of these 3 visual complications is discussed in more detail below. Hypertensive retinopathy is the most common ocular manifestation of preeclampsia and eclampsia, occurring in 60% of patients.15 Focal arteriolar spasm and narrowing is commonly seen and may be associated with secondary changes eg, diffuse retinal edema, hemorrhages, exudates, and nerve fiber layer infarcts [cotton wool spots] ; . The degree of retinopathy usually correlates with the severity of preeclampsia, 16 as well as APGAR scores 16 and fetal mortality.17 Arterial narrowing is reversible following pregnancy in the majority of patients.17 Exudative retinal detachment occurs in 1% of preeclamptic patients and up to 10% of eclamptic patients.13, 14, 18 It is thought to be caused by choroidal ischemia.19 IVFA shows delayed filling of the choriocapillaries with normal retinal vasculature, 20 as well as choroidal non-filling with late fluorescein extravasation into subretinal and subpigment epithelial spaces.21, 22 Retinal pigment epithelium RPE ; lesions, called Elschnig spots, may also be found in preeclamptic patients with choroidal infarcts 23. The prognosis is good, with visual symptoms and RPE changes resolve spontaneously within weeks of delivery.17, 23 OCT is an effective, non-invasive tool for following the evolution of fundus changes in these patients.24 Cortical blindness refers to reduced vision from bilateral damage to any portion of the visual pathways posterior to the lateral geniculate nucleus. Eye examination is typically normal, including a normal pupillary light reflex. It occurs in up to 15% of preeclampsia and eclampsia.25, 26 It can present both ante- and postpartum, 26 lasting from several hours to several days. Other presenting symptoms include headache, seizures, and loss of consciousness. Investigations include computed tomography CT ; or magnetic resonance imaging MRI ; of the brain. CT reveals bilateral low-density lesions in the occipital cortex, 25, 27-29 while MRI.
If this drug is used in women of childbearing potential, or during pregnancy, or if a patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.
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