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WELL Duquesne University Mylan School of Pharmacy
UPDATE from the Center for Pharmacy Care
November -December 2006
New Vaccines: Give Them a Shot!
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wo vaccines are now available that may have a significant impact on public health. One is intended to decrease the frequency of cervical cancer and the other will hopefully reduce the occurrence of shingles, a late complication of infection with the chickenpox virus. The following descriptions provide some basic information on these new vaccines. As always, readers are encouraged to discuss this information with their physicians.
Remember Your Flu Shot!
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he Centers for Disease Control and Prevention (CDC) estimates that 5-20 percent of the U.S. population will develop influenza (also known as flu) this year. In most instances, the disease is relatively mild. However, nearly 200,000 cases result in complications and the yearly fatality rate is approximately 36,000. Nine out of 10 deaths occur in those who
Upcoming Events
HPV Vaccine Human papillomavirus (HPV) is now recognized as the major cause of cervical cancer. This type of cancer kills more than 200,000 women worldwide every year. HPV is a very common sexually transmitted virus that most people (men and women) will get at some point in their lives. The majority of those infected are unaware of its presence because of the absence of symptoms and ability of the are 65 years of age or older. Interestingly, the highest infection rates are seen in children and many cases require hospitalization. Most immunization programs begin in October, but the vaccine can be administered in the following months as well. The vaccine is considered to be effective in up to 90 percent of healthy adults younger than 65 years. Although somewhat less effective in older individuals, the severity of symptoms can be reduced by administering the vaccine. Influenza vaccine may be given
body to clear the virus. Sometimes, however, the virus lingers, causing changes in the cervix that could turn into cancer. Some sources suggest that the development of cervical cancer depends on a variety of co-factors, including smoking, multiple births, long-term use of oral contraceptives and HIV infection. In addition to cervical cancer, HPV is associated with the development of vaginal tissue changes and genital warts. There are more than 100 types continued on back
as a shot or by inhalation (5 to 49 years of age). Patients may complain of localized pain after the injection, low-grade fever, or fatigue. However, there is no evidence the vaccine can cause influenza. It is expected that more than 100 million doses of vaccine will be available this year – an increase of nearly 19 million doses over the 2005-2006 season. All children ages six to 59 months and adults 50 years and older should receive influenza vaccine. Have you made arrangements to get your flu shot?
Mark Your Calendar
NOVEMBER – American Diabetes Month Center for Pharmacy Care–Wellness Mondays • November 6, 13, & 27 Location: 320 Bayer, 9:00 a.m.-3:00 p.m. Center for Pharmacy Care–Wellness Wednesdays for students! • November 8, & 29 Location: 320 Bayer, 1:00-3:00 p.m. Blood Pressure Screening • November 8 & 29 Location: Union Concourse , 2nd Floor, Atruim 10:00 a.m.-noon Diabetes Awareness Day Screening–diabetes risk assessment, blood glucose screening & more! • November 16 Location: 320 & 318 Bayer 9:00 a.m.-noon, 1:00-3:00 p.m.
DECEMBER – National Handwashing Awareness Week, December 3-9 Center for Pharmacy Care–Wellness Mondays • December 4, 11, & 18 Location: 320 Bayer, 9:00 a.m.-3:00 p.m. Center for Pharmacy Care–Wellness Wednesdays for students! • December 13 Location: 320 Bayer, 1:00-3:00 p.m. Blood Pressure Screening • December 13 Location: Union Concourse , 2nd Floor, Atruim 10:00 a.m.-noon
TOBACCO CESSATION PROGRAM The Center for Pharmacy Care offers a five-week tobacco cessation program. Any employee or student interested in joining a group to quit tobacco should call x5874. Dates will be determined after sign-up. NEW WELLNESS WEDNESDAYS FOR STUDENTS By appointment, the following complimentary screenings are offered on Mondays (employees) and Wednesdays (students): bone density, body composition analysis, facial skin analysis, cholesterol screening and glucose testing for diabetes. Please call 412-396-5874 for an appointment.
www.duq.edu
New Vaccines: Give Them a Shot! of HPV, but fewer than 20 are considered “high risk” for the development of cervical cancer. In June 2006, the Food and Drug Administration approved an HPV vaccine that is expected to be available late this year. Gardasil® is an inactivated (not live) vaccine that protects against two types of HPV (HPV 16 and 18) that are associated with approximately 70 percent of all cervical cancers. It also protects against the two types of HPV (HPV 6 and 11) that cause almost 90 percent of genital warts. Other types of HPV virus will not be prevented by use of this vaccine. The government’s Advisory Committee on Immunization Practices (ACIP) has recommended that the vaccine be administered to girls 11 to 12 years of age and to some as young as 9 years at the discretion of their physician. Those 13 to 26 years of age who have not been vaccinated are advised to receive “catch up” immunizations. Anyone with a history of life-threatening allergic reaction to yeast, any other component of HPV vaccine, or previous dose of HPV vaccine should not receive this product. The vaccine appears to be safe for use during pregnancy. However, it has not been sufficiently studied to recommend its routine use during this period. Those who are breastfeeding can safely receive the vaccine. People with moderate or severe illnesses should wait until they recover before receiving HPV vaccine. This vaccine is administered by intramuscular injection in a series of three shots over a six month period. Once vaccinated, women are protected against the virus for more than four years. At this time, the need for a booster dose has not been established. The price of HPV vaccine is currently about $120 per dose and, as stated earlier, full protection requires the use of three doses. This figure does not include the cost for giving the injections or the physician fee. Insurance plans are
For additional information on these conditions and vaccines, please visit:
expected to cover the cost in accordance with ACIP recommendations. The use of HPV vaccine does not eliminate the requirement for a yearly Pap test. The combination of these two preventive measures can significantly decrease the risk of cervical cancer.
Varicella-Zoster (Shingles) Vaccine Chickenpox is a common childhood disease caused by the varicella-zoster virus. After the disease clears, the virus may remain inactive, but present for many years. Re-activation of the zoster virus later in life results in the condition known as shingles. The disorder affects 500,000 Americans each year and can occur in any of the 90 percent of American adults who previously had chickenpox. It generally affects people over the age of 50 and the risk continues to increase with age. The risk also is higher in those with impaired immune systems. Shingles begins as a rash on one side of the body. The rash subsequently turns into fluid-filled blisters that become encrusted and heal in three to five weeks. Burning or tingling of the skin, flu-like symptoms (fever, chills and headache), sensitive skin, itching and severe pain may accompany the rash. While shingles is not contagious, scratching and rupturing the blisters may result in infection and/or scarring. Opened blisters can result in transfer of the virus to infants who have never been exposed to varicella. For this reason, it is crucial that patients with shingles avoid exposure to pregnant women and infants
Newsletter Contributors
• www.zostavax.com
John G. Lech, Pharm.D.
• http://www.nlm.nih.gov/medlineplus/ shingles.html
Michael A. DeCoske, Pharm.D. Candidate
• www.cancer.gov/cancertopics/hpvvaccines • http://www.cdc.gov/std/hpv/STDFactHPV-vaccine.htm
Allison M. Simons, Pharm.D. Candidate
less than 12 months of age. Unfortunately, long after the rash and blisters have cleared, many people continue to suffer from the severe pain of shingles. This condition is known as postherpetic neuralgia (PHN). PHN is a sharp, throbbing pain in the area where the rash had been present. The severity and chronic nature of the pain can lead to depression, anxiety and difficulty in performing even simple tasks and may take months to years to resolve. Treatment of shingles may be accomplished with many topical medications and/or drugs taken by mouth. Pain can usually be relieved by analgesics such as acetaminophen or ibuprofen. Severe pain may require the use of narcotic analgesics. Over-the-counter (OTC) medications like capsaicin cream (Capsin®, Zostrix®, etc.) also may be beneficial for PHN. Zostavax®, a live varicella-zoster vaccine, was approved by the FDA in May 2006. It is indicated for those 60 years of age or older. The vaccine has been shown to increase immunity against the virus and prevent its reactivation. Zostavax® is administered as a single injection into the upper arm. Adverse effects include redness, pain and swelling at the injection site, headache and itching. It is still possible to develop shingles after the vaccine has been administered. However, the duration and severity of the condition are reduced, as is the potential for developing PHN. Patients with weakened immune systems should not receive the vaccine. Neither should those with allergies to neomycin (a preservative) or gelatin. At present, the duration of immunity and requirements for booster doses have not been established.
A publication of the Duquesne University Mylan School of Pharmacy Center for Pharmacy Care & Pharmaceutical Information Center (PIC) Additional information on any of the topics discussed may be obtained from the Pharmaceutical Information Center by calling 412-396-4600 or sending an e-mail to pic@duq.edu. Questions about screenings or programs: Christine O’Neil, Pharm.D, B.C.P.S., 412-396-6417 10/06 312639 CG