In this episode, we announce the debut of the HelixTalk Drug Superlative Awards -- awards given to medications on the market that are outstanding or notorious. In announcing these completely fictitious awards, we review key clinical pearls and pitfalls that every clinician should be aware of with these medications.

Key Concepts

1. Drug most likely to be remembered for COVID-19 ineffectiveness rather than its actual FDA indication: hydroxychloroquine
2. Commonly used but worst hypertensives on the market: it’s a tie! Atenolol and hydrochlorothiazide.
3. Most confusing dosage forms: valproic acid, valproate sodium, and divalproex -- it’s all the same thing!
4. Most innovative prodrug: valacyclovir
5. Hottest inactive ingredient: it’s a tie! Sulfobutylether-beta-cyclodextrin (SBECD), an excipient in remdesivir, and polyethylene glycol (PEG), an excipient in mRNA vaccines.

In this episode, we will discuss basic pharmacology and use of naloxone, available formulations, evidence for its effectiveness, and naloxone-related pharmacy management and regulations.

Key Concepts

1. Naloxone, available in various formulations, is a quick-acting opioid reversal agent approved for use in opioid overdose cases.
2. Naloxone access laws are in place in the majority of the states allowing patients and caregivers to obtain the medication as well as administer naloxone.
3. These access laws allow pharmacists to dispense naloxone to patients without individual prescriptions under prescriptive authority, standing/protocol orders, or collaborative agreements. Registration, training, education, and reporting requirements may vary per individual state.
4. Despite such access laws, overall prescribing of naloxone per high-dose opioid prescriptions remain low. Not many studies are available, but some suggest these laws help reduce opioid overdose deaths and emergency department visits. Implementation and education about such laws need to be improved.

References

• Prescription Drug Abuse Policy System. Naloxone Overdose Prevention Laws. http://pdaps.org/datasets/laws-regulating-administration-of-naloxone-1501695139
• Naloxone finder. https://www.getnaloxonenow.org/#getnaloxone
• Illinois Department of Public Health. Naloxone. https://www.dph.illinois.gov/naloxone
• Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naloxone
• A Way Out. https://www.opioidinitiative.org/awayout