April 25th, 2023: Biosimilars, Mifegymiso, and Acute Migraine

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https://mailchi.mp/usask.ca/medsask-newsletter-april-25-2023?e=[UNIQID] 

Summary/Highlights

• Drug Shortages 
  • Glucagon injectable
• Saskatchewan Biosimilars Initiative
  • Insulin lispro comparison chart, biosimilar insulin safety labels, and adalimumab comparison chart
• Professional Practice 
  • Minor ailments: managing acute migraine headache
  • Access to Mifegymiso
• From the medSask database 
  • Alternative intramuscular injection sites
  • Filter needles and drawing up from ampules
  • Maya's resource share: A quick reference guide for pediatric and neonatal dosing information 
• Share your feedback with medSask! Help us create a valuable newsletter each month by completing a short (2-minute) survey.

References

References are recorded in the order in which they appear. 

1. Drug Shortages and Discontinuations. medSask. University of Saskatchewan. Updated April 17, 2023. Accessed April 17, 2023. https://medsask.usask.ca/professional-practice/drug-shortages
2. Hypoglycemia: low blood sugar in adults. Diabetes Canada. Updated March 2018. Accessed April 17, 2023. https://guidelines.diabetes.ca/docs/patient-resources/hypoglycemia-low-blood-sugar-in-adults.pdf
3. Regier L. Topical Corticosteroids: Comparison Chart. RxFiles. University of Saskatchewan. Updated December 2022. Accessed April 17, 2023. https://www.rxfiles.ca/RxFiles/uploads/documents/members/CHT-SteroidClassPotencyCOLOR.pdf
4. Biosimilars in Saskatchewan. University of Saskatchewan. Updated April 2023. Accessed April 17, 2023. https://medsask.usask.ca/professional-practice/biosimilars-in-Saskatchewan
5. Minor Ailment FAQs. medSask. University of Saskatchewan. Updated March 6, 2023. Accessed April 17, 2023. https://medsask.usask.ca/minor-ailment-guidelines/FAQshttps://medsask.usask.ca/minor-ailment-guidelines/FAQs
6. Clinical Resource, Comparison of Triptans. Pharmacist’s Letter/Pharmacy Technician’s Letter. February 2021. [370229]
7.  Clinical Resource, Oral Meds to Keep in Original Containers. Pharmacist’s Letter/Pharmacy Technician’s Letter/Prescriber’s Letter. April 2023. [390430]
8. Foong AL, Grindrod KA, Patel T, Kellar J. Demystifying serotonin syndrome (or serotonin toxicity). Can Fam Physician. 2018 Oct;64(10):720-727. PMID: 30315014; PMCID: PMC6184959.
9. Regier L, Jensen B, Downey S, Crawley A. MIGRAINE: Acute Therapy. RxFiles Drug Comparison Charts. Saskatoon, SK: University of Saskatchewan. [updated Nov 2022; accessed 20 Apr 2023].
10. Worthington I, Pringsheim T, Gawel MJ, Gladstone J, Cooper P, Dilli E, Aube M, Leroux E, Becker WJ. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Canadian Journal of Neurological Sciences. 2013 Sep;40(S3):S1-3.
11. Schwedt T, Garza I. Acute treatment of migraine in adults. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com   (Updated Mar 14 2023, Accessed 20 Apr 2023) Subscription required.
12. Chen YS, Lee HF, Tsai CH, Hsu YY, Fang CJ, Chen CJ, Hung YH, Hu FW. Effect of Vitamin B2 supplementation on migraine prophylaxis: a systematic review and meta-analysis. Nutr Neurosci. 2022 Sep;25(9):1801-1812. doi: 10.1080/1028415X.2021.1904542. Epub 2021 Mar 29. PMID: 33779525.
13.  DISPENSING MIFEGYMISO® Guidance for Pharmacy Professionals. SCPP Reference Manual. Updated April 2019, cited April 2023. Available from: https://scp.in1touch.org/document/3692/Mifegymiso_Dispensing_Gdlns_20170829.pdf
14. Mifegymiso-Information for the prescribing physician. College of Physicians and Surgeons of Saskatchewan. Updated April 2019, cited April 2023. Available from: https://www.cps.sk.ca/iMIS/Documents/Mifegymiso%20-%20info%20for%20physicians%202019.pdf
15. Mifegymiso Product Monograph. https://pdf.hres.ca/dpd_pm/00068788.PDF
16. Administration of Drugs by Injection and Other Routes Guidelines. Saskatchewan College of Pharmacy Professionals. Updated September 26, 2022. Accessed April 13, 2023. https://www.saskpharm.ca/document/3614/REF_Injection_Admin_Gdlns_20171213.pdf 
17. “Administration Routes, Sites, and Techniques”. In: Chapter 8 – Administration of Biological Products. Saskatchewan Immunization Manual. Government of Saskatchewan Ministry of Health. Updated February, 2022. Accessed March 20, 2023. https://www.ehealthsask.ca/services/manuals/Documents/sim-chapter8.pdf#page=17 
18. Cornwall J. Are nursing students safe when choosing gluteal intramuscular injection locations? Australas Med J. 2011;4(6):315-21. doi: 10.4066/AMJ.2011764. Epub 2011 Jun 30. PMID: 23386894; PMCID: PMC3562949. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/.
19. Medication Administration: Intramuscular Injection – CE. Elsevier Health. RELX Group. Published November 22, 2022. Accessed April 21, 2023. Available from: https://elsevier.health/en-US/preview/intramuscular-injections-acute-care#ref6 
20. IM Ventrogluteal Adult FINAL. ImmunizeBC. September 25, 2014. Accessed March 20, 2023. https://youtube.com/watch?v=orBAy6Aqc9k&si=EnSIkaIECMiOmarE 
21. Oberholzer W. Physicians and sensitive examinations. College of Physicians and Surgeons Saskatchewan. February 8, 2021. Accessed March 20, 2023. Available from: https://www.cps.sk.ca/iMIS/Documents/DocTalk/08.01/2021.02.08%20Sensitive%20examinations%20CPSS%20Guidance%20document.pdf 
22.  “Appendix B – Administration of Biological Products”. Chapter 2: Immunization. Communicable Disease Control Manual. BC Centre for Disease Control. Updated June, 2022. Accessed March 20, 2023. http://www.bccdc.ca/resource-gallery/Documents/Guidelines%20and%20Forms/Guidelines%20and%20Manuals/Epid/CD%20Manual/Chapter%202%20-%20Imms/Appendix_B_Administration.pdf 
23. Delatestryl [Prescribing Information]. Laval, Quebec. Valent International. 2014. Accessed March 20, 2023. https://pdf.hres.ca/dpd_pm/00026379.PDF 
24. Abilify Maintena [Product Monograph]. Saint-Laurent, Quebec. Lundbeck Canada Inc. 2021. Accessed March 20, 2023. https://pdf.hres.ca/dpd_pm/00060200.PDF 
25. Clopixol [Product Monograph]. Saint-Laurent, Quebec. Lundbeck Canada Inc. 2020. Accessed March 20, 2023. https://www.lundbeck.com/content/dam/lundbeck-com/americas/canada/products/files/clopixol_product_monograph_english.pdf 
26. Risperidal Consta [Product Monograph]. Toronto, Ontario. Janssen Inc. 2017. Accessed April 13, 2023. https://pdf.hres.ca/dpd_pm/00040784.PDF 
27. Haloperidol Deconate Injection [Product Monograph]. Etobicoke, Ontario. 2014. Accessed April 13, 2023. https://pdf.hres.ca/dpd_pm/00025917.PDF 
28. Filtered Needles for Withdrawing Medication from Glass Ampoules: A Review fo the Cost Effectiveness and Incidence of Complications. Health Technology Inquiry Service. Canadian Agency for Drugs and Technologies in Health (CADTH). Published February 24, 2010. Accessed April 17, 2023. https://www.cadth.ca/sites/default/files/pdf/L0158_Filtered_needles_final_no_abs.pdf
29. Standard for the Administration of Immunizations. Vaccine Administration Standards. Alberta Health Services. Updated January 1, 2020. Accessed April 17, 2023. https://www.albertahealthservices.ca/assets/info/hp/cdc/if-hp-cdc-ipsm-standard-administration-immunization-06-100.pdf
30. Communicable Disease Control Manual. BC Centre for Disease Control. Updated June 2022. Accessed April 17, 2023. http://www.bccdc.ca/resource-gallery/Documents/Guidelines%20and%20Forms/Guidelines%20and%20Manuals/Epid/CD%20Manual/Chapter%202%20-%20Imms/Appendix_B_Administration.pdf
31. Chapter 8: Administration of Biological Products. Saskatchewan Immunization Manual. Government of Saskatchewan Ministry of Health. Updated June 2018. Accessed April 17, 2023. https://www.ehealthsask.ca/services/manuals/Documents/sim-chapter8.pdf
32. Decision Support Tool: Drawing Medications from a Glass Ampoule and the Use of Filter Needles. Population and Public Health. Winnipeg Regional Health Authority. Published August 16, 2018. Accessed April 17, 2023. https://professionals.wrha.mb.ca/old/professionals/immunization/files/SupportMedicationsglassampoulefilterneedles.pdf
33. BC Children’s and Women’s Hospital (C&W) Online Formulary (PedMed). Department of Pharmacy. Children’s & Women’s Health Centre of British Columbia. Updated 2022. Accessed April 14, 2023. http://www.pedmed.org/DrugApp/index.html 
    

March 29, 2023: Flu Season, Ramadan, and COVID-19 Vaccine Update

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https://mailchi.mp/usask.ca/medsask-newsletter-march-29-2023?e=[UNIQID] 

Summary/Highlights

• You can read the medSask newsletter in another language!
• COVID-19 Vaccine Update
  • Moderna Spikevax^TM BA.4/5 off-label administration for children 6-17 years of age
  • Expanded booster dose eligibility for select populations
• Drug Shortages
  • Nitroglycerin sublingual spray  
  • Teva-prazosin tablets
• Saskatchewan Biosimilars Initiative
  • Minimizing medication errors
• Professional Practice
  • Coronavirus, influenza, RSV…and now Seasonal Allergies!
  • Ramadan and Medication Use
  • Prevnar 20^TM and Vaxneuvance® - What do pharmacists need to know?
• From the medSask database
  • Beyond use date considerations for medications in vials
  • Sara's resource share – talking points for individuals interested in cannabis
• Share your feedback with medSask! Help us create a valuable newsletter each month by completing a short (2-minute) survey.

References

References are recorded in the order in which they appear. 

1. Permitted Off-label Administration of Moderna Spikevax BA.4/5 Bivalent Vaccine to Children 6-17 Years Old. Saskatchewan Ministry of Health. March 14, 2023. https://www.ehealthsask.ca/services/Manuals/Documents/Moderna%20Spikevax%20BA.45%20Bivalent%20off-label%20use%20permitted%20for%206-17%20years%202023-03-14.pdf
2. Spring 2023 Second COVID-19 Bivalent Booster Dose Eligibility and Interval Recommendations. Saskatchewan Ministry of Health. Updated March 23, 2023. Accessed March 27, 2023. https://saskpharm.ca/document/10925/MoH_Second_Bivalent_COVID_Booster_Eligibility_20230323.pdf
3. Drug Shortages and Discontinuations. medSask. University of Saskatchewan. Updated March 27, 2023. Accessed March 27, 2023. https://medsask.usask.ca/professional-practice/drug-shortages
4. Patient Presents with Prescription for NTG Spray or Requests NTG Spray (schedule 2 drug). Canadian Cardiovascular Society and Canadian Cardiovascular Pharmacists Network. Updated March 17, 2023. Accessed March 27, 2023. https://ccs.ca/app/uploads/2023/03/Guidance-Tool_Shortage-of-Nitroglycerin-Sprays-in-Canada.pdf
5. Shortage of Nitroglycerin Sprays In Canada. Recalls and Safety Alerts. Government of Canada. Updated March 17, 2023. Accessed March 22, 2023. https://recalls-rappels.canada.ca/en/alert-recall/shortage-nitroglycerin-sprays-canada
6. Biosimilars in Saskatchewan. University of Saskatchewan. Updated March 2023. Accessed March 24, 2023. https://medsask.usask.ca/professional-practice/biosimilars-in-Saskatchewan
7. DynaMed. Allergic Rhinitis. EBSCO Information Services. Accessed March 17, 2023. https://www.dynamed.com/condition/allergic-rhinitis. 
8. Keith, P. Allergic Rhinitis. In: Therapeutics [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2023 [updated Mar 2022; cited 2023 Mar 17]. Available from: http://www.myrxtx.ca. Also available in paper copy from the publisher.
9.  Kendrick J. Allergic Rhinitis. In: Minor Ailments [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2023 [updated Mar 2022; cited 2023 Mar 17]. Available from: http://www.myrxtx.ca . Also available in paper copy from the publisher.
10. Abolaban H, Al-Moujahed A. Muslim patients in Ramadan: A review for primary care physicians. Avicenna J Med. 2017 Jul-Sep;7(3):81-87. doi: 10.4103/ajm.AJM_76_17. PMID: 28791239; PMCID: PMC5525471. 
11. Grindrod K, Alsabbagh W. Managing medications during Ramadan fasting. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada. 2017 May;150(3):146-9.
12. Ramadan and Diabetes. Diabetes Canada Clinical Practice Guidelines. Published April 27, 2018. Accessed March 24, 2023. https://guidelines.diabetes.ca/healthcareprovidertools/ramadan-and-diabetes
13. Akhtar AM, Ghouri N, Chahal CAA, Patel R, Ricci F, Sattar N, Waqar S, Khanji MY. Ramadan fasting: recommendations for patients with cardiovascular disease. Heart. 2022 Feb;108(4):258-265. doi: 10.1136/heartjnl-2021-319273. Epub 2021 May 14. PMID: 33990414; PMCID: PMC8819657.
14. Pharmacy 5in5. Ramadan and Medication. University of Waterloo Faculty of Science School of Pharmacy. 2017. Accessed March 24, 2023. https://www.youtube.com/watch?v=LJ5qCgPJJ0U
15. Summary of National Advisory Committee on Immunization (NACI) Statement of February 2023: Public health level recommendations on the use of pneumococcal vaccines in adults, including the use of 15-valent and 20-valent conjugate vaccines. Public Health Agency of Canada. Published February 24, 2023. Accessed March 14, 2023. https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/summary-february-24-2023.pdf
16. An Advisory Committee Statement (ACS): Public health level recommendations on the use of pneumococcal vaccines in adults, including the use of 15-valent and 20-valent conjugate vaccines. Public Health Agency of Canada. Published February 24, 2023. Accessed March 14, 2023. https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/public-health-level-recommendations-use-pneumococcal-vaccines-adults-including-use-15-valent-20-valent-conjugate-vaccines/recomme
17. Pneumococcal vaccine. Canadian Immunization Guide. Government of Canada. Updated February 28, 2023. Accessed March 14, 2023. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-16-pneumococcal-vaccine.html
18. Pneumococcal Vaccination Recommendations. medSask. University of Saskatchewan. Updated April 2015. Accessed March 14, 2023. Internal PDF.
19. Prevnar 20 Health Care Professional Leaflet. Pfizer Canada ULC. 2023. Accessed March 16, 2023. https://webfiles.pfizer.com/ENPNR20HCPLEAFLET?referrer=3d560995-33e1-433f-85cf-a1638b95c2e7
20. Disease Prevention and Travel Health Services Policy and Framework for Saskatchewan Pharmacists. Saskatchewan College of Pharmacy Professionals. Updated April 29, 2021. Accessed March 24, 2023. https://saskpharm.ca/document/5410/REF_Travel_Health_Disease_Prevention_Travel_Health_Services_Frmwk.pdf 
21. Vaccine Preventable Disease and Travel Health. medSask. University of Saskatchewan. Accessed March 24, 2023.  https://medsask.usask.ca/restricted-guidelines/vaccine-preventable-disease-and-travel-health 
22. Disease Prevention and Travel Health Services. Continuing Professional Development for Pharmacy Professionals. University of Saskatchewan. Accessed March 24, 2023. https://pharmacy-nutrition.usask.ca/cpdpp/continuing-education-/travel-health.php
23. Model Standards for Pharmacy Compounding of Hazardous Sterile Preparations. National Association of Pharmacy Regulatory Authorities (NAPRA). Updated September 2016. Accessed March 14, 2023. https://www.napra.ca/wp-content/uploads/2022/09/NAPRA-Mdl-Stnds-Pharmacy-Compounding-Hazardous-Sterile-Preparations-Nov-2016-Revised-b.pdf
24. Drug Product Database Online Query. Health Canada. Accessed March 23, 2023.  https://health-products.canada.ca/dpd-bdpp/
25. Email communication with Bausch Health. Received March 22, 2023. 
26. Cannabis for Medical Purposes: How to help patients find a safe and effective dose. Canadian Pharmacists Association. 2018. Accessed March 16, 2023. https://www.pharmacists.ca/cpha-ca/assets/File/education-practice-resources/Cannabis%20Dosing%20and%20Titrating%20Final_web.pdf
27. Cannabis for Medical Purposes: How to Start the Conversation. Canadian Pharmacists Association. 2018. Accessed March 16, 2023. https://www.pharmacists.ca/cpha-ca/assets/File/cpha-on-the-issues/CannabisTool_StartConversation.pdf 
    

February 28, 2023: Biosimilars and Domperidone

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https://mailchi.mp/usask.ca/medsask-newsletter-february-28-2023?e=[UNIQID]

Summary/Highlights

• Saskatchewan Biosimilars Initiative
  • Support tools for pharmacists: A-PAR, Insulin Glargine and Insulin Aspart Comparison Charts, and the Transitioning to a Biosimilar Insulin infographic
  • Register to receive the recording from the biosimilar insulin webinar
  • Live biosimilar Q&A: March 8th, 2023
• Professional Practice
  • Domperidone Use in Breastfeeding/Chestfeeding: health care professional handout and patient handout
  • Need to Know Information about Norovirus
• From the medSask database
  • A question from the lines: Alternatives to valproic acid capsules during drug shortage?
  • Shavan's resource share: Merck Manual Professional Version

References

References are recorded in the order in which they appear. 

1. Biosimilars in Saskatchewan. University of Saskatchewan. Updated February 2023. Accessed February 14, 2023. https://medsask.usask.ca/professional-practice/biosimilars.php
2. Sawin, S. Domperidone Use in Breastfeeding/Chestfeeding, Healthcare Professional Handout. medSask, University of Saskatchewan. Published January 20, 2023. Accessed February 14, 2023.  https://medsask.usask.ca/documents/domperidone-healthcare-professional-handout.pdf
3. Sawin, S. Domperidone Use in Breastfeeding/Chestfeeding, Patient Handout. medSask, University of Saskatchewan. Published February 8, 2023. Accessed February 21, 2023.  https://medsask.usask.ca/documents/domperidone-healthcare-professional-handout.pdf
4. National Collaborating Centre for Infectious Diseases. Disease Debrief – Norovirus. Updated January 23, 2023. Cited February 20, 2023. Available from https://nccid.ca/debrief/norovirus/
5. Centers for Disease Control and Prevention. About Norovirus. Updated March 5, 2021. Cited February 20, 2023. Available from:   https://www.cdc.gov/norovirus/about/index.html
6. Government of Canada. Pathogen safety data sheets: Infectious substances – Norovirus. Updated 11-24-2020. Accessed 02-20-2023. Available from:
7. https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/norovirus-pathogen-safety-data-sheet.html#sec4
8. Hughes C and Petrucha R.  Nausea and Vomiting. In: Therapeutic Choices [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2023 [updated Apr 2021; cited 2023 Feb 20]. Available from: http://www.myrxtx.ca. Also available in paper copy from the publisher.
9. Jobson MD. Alexandraki I, Smetana G. Acute viral gastroenteritis in adults. UpToDate. Wolters Kluwer. Accessed February 20, 2023. https://www.uptodate.com (Subscription required).
10. O’Ryan M. Acute viral gastroenteritis in children in resource-rich countries: Management and prevention. UpToDate. Wolters Kluwer. Accessed February 20, 2023. https://www.uptodate.com (Subscription required).
11. Nausea and Vomiting in Adults. EBSCO Information Services. Accessed February 20, 2023. https://www.dynamed.com/approach-to/nausea-and-vomiting-in-adults
12. Acute Viral Gastroenteritis in Children. EBSCO Information Services. Accessed February 20, 2023. https://www.dynamed.com/condition/acute-viral-gastroenteritis-in-children
13. Jensen B, Crawley A, LeBras M. Seizures: Antiseizure Drug Comparison Chart. RxFiles, University of Saskatchewan. Updated Jan 2023. Accessed February 17, 2023.
14. Drug Shortages and Discontinuations. University of Saskatchewan. Updated February 14, 2023. Accessed February 17, 2023. https://medsask.usask.ca/professional-practice/drug-shortages.php
15. Saskatchewan Drug Plan. Saskatchewan Online Formulary Database. Government of Saskatchewan, Regina, SK. Accessed February 17, 2023. http://formulary.drugplan.health.gov.sk.ca/SearchFormulary
16. McKesson Canada. PharmaClik. Accessed February 17, 2023.  http://clients.mckesson.ca (Account required).
17. Merck Manual Professional Version. Merck & Co., Inc.; 2023. Accessed February 14, 2023. https://www.merckmanuals.com/en-ca/professional

January 31, 2023: Drug Shortages and COVID-19 Booster Dose Eligibility

Read Now

https://mailchi.mp/usask.ca/medsask-newsletter-january-31-2023?e=[UNIQID]

Summary/Highlights

• COVID-19 booster dose eligibility update
• Drug shortages: testosterone and liquid antibiotic suspensions
• Saskatchewan Biosimilars Initiative: biosimilar key points infographic 
• From the medSask database
  • Dukoral® requires a prescription to dispense in Saskatchewan
  • Dispensing and prescribing Paxlovid® for out-of-province or out-of-country individuals
  • Completing a hepatitis A vaccine series
  • Kelsey’s Resource Share: Canadian Probiotic Chart

References

References are recorded in the order in which they appear. 

1. Saskatchewan Ministry of Health. COVID-19 Booster Dose Clarification and Revision to Interval [Internet]. Regina, SK; [published 2023 Jan 26; cited 2023 Jan 31]. Available from: https://saskpharm.ca/document/10427/COVID-19_Booster_Dose_Clarfication_Interval_Revision_20230126.pdf 

2. Determining COVID-19 Booster Dose Eligibility in Saskatchewan. COVID-19 Vaccine Doses/Eligibility/Intervals [Internet]. medSask; 2023 [updated 2023 Jan 30; cited 2023 Jan 31]. Available from: https://medsask.usask.ca/documents/covid-documents/winter-booster-eligiblity.pdf 
3. eHealth Saskatchewan. Saskatchewan Immunization Manual. Government of Saskatchewan. [updated 2023 Jan; cited 17 Jan 2023] Available at https://www.ehealthsask.ca/services/manuals/Pages/SIM.aspx  

4. Government of Saskatchewan. Vaccine Delivery Phases [Internet]. Saskatchewan: Government of Saskatchewan; Publication 2023 [cited 2023 Jan 17]. Available from: https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus/covid-19-vaccine/vaccine-delivery-phases 
5. medSask. Drug Shortages and Discontinuations [Internet]. Saskatoon, SK; 2022 [cited 2023 Jan 9]. Available from: https://medsask.usask.ca/professional-practice/drug-shortages.php 
6. Bell C, Nijaar G. Injectable and Oral Testosterone Shortage. Drug Shortages and Discontinuations [Internet]. medSask; 2012 [updated 2023 Jan; cited 2023 Jan 26]. Available from: https://medsask.usask.ca/documents/drug-shortages-pdfs/testosterone.pdf 
7. medSask. Liquid Antibiotic Shortage [Internet]. Saskatoon, SK; 2023 [cited 2023 Jan 12]. Available from: https://medsask-usask-ca.cyber.usask.ca/general-public/liquid-antibiotic-shortage.php 
8. At Home with Children with Respiratory Infections?. Liquid Antibiotic Shortage [Internet]. medSask; 2022 [cited 2023 Jan 25]. Available from: https://medsask.usask.ca/documents/home-with-sick-children-infographic-dec-22.pdf 
9. Do Bugs Need Drugs?. Guide to Wise Use of Antibiotics [Internet]. Alberta: Communicable Disease Control Program, Alberta Health Services; 2022 [cited 2023 Jan 13]. Available from: https://dobugsneeddrugs.org/guide-to-wise-use-of-antibiotics/ 

10. What are Biosimilars? [image]. medSask; 2023 [cited 2023 Jan 26]. 

11. Travel Health Services and Vaccine-Preventable Diseases FAQ. Saskatchewan College of Pharmacy Professionals; 2021 Sept 28 [cited 2023 Jan 9]. Available from: https://saskpharm.ca/document/5581/REF_Travel_Health_FAQs.pdf 
12. National Association of Pharmacy Regulatory Authorities (NAPRA) [Internet]. National Drug Schedules. Ontario, ON: NAPRA; 1996. Available from: https://www.napra.ca/national-drug-schedules/medSask . 
13. Vaccine Preventable Disease and Travel Health [Internet]. Saskatoon, SK; 2021 [cited 2023 Jan 9]. Available from: https://medsask.usask.ca/professional-practice/restricted-guidelines/vaccine-preventable-disease-and-travel-health.php 
14. Disease Prevention and Travel Health Services Policy and Framework for Saskatchewan Pharmacists. Saskatchewan College of Pharmacy Professionals; 2021 April 29 [cited 2023 Jan 9]. Available from: https://saskpharm.ca/document/5410/REF_Travel_Health_Disease_Prevention_Travel_Health_Services_Frmwk.pdf 
15. Public Health Agency of Canada. Cholera and enterotoxigenic escherichia coli (ETEC) travellers' diarrhea vaccine: Canadian Immunization Guide. Ottawa: Government of Canada; [updated 2017 April; cited 2023 Jan 9]. Available from: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-3-cholera-enterotoxigenic-escherichia-coli-travellers-diarrhea-vaccine.html 
16. Pharmacy FAQs #2 on Paxlovid™. Saskatchewan Drug Plan [Internet]. COVID-19 Immunization Manual, Government of Saskatchewan; 2022 [cited 2023 Jan 10]. Available from: https://formulary.drugplan.ehealthsask.ca/PDFs/Pharmacy%20FAQs%202%20-%20Paxlovid.pdf 
17. Bell C. Hepatitis A and Hepatitis B Vaccines: Recommendations for Interrupted Schedules, Booster Doses, Repeat Doses, & Last Minute Travellers. Drug Shortages and Discontinuations [Internet]. medSask; 2020 [updated 2022 Nov; cited 2023 Jan 10]. Available from: https://medsask.usask.ca/documents/mednews-docs/hepatitis_vaccines.pdf 
18. Public Health Agency of Canada. Hepatitis A vaccine: Canadian Immunization Guide. Ottawa: Government of Canada; [updated 2018 March; cited 12 Jan 2023]. Available from https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-6-hepatitis-a-vaccine.html#p4c5t2 
19. Immunize.org  [Internet]. Saint Paul, MN: Immunize.org. Hepatitis A; 2021 Dec 10 [cited 2023 Jan 12]. Available from: https://www.immunize.org/askexperts/experts_hepa.asp 
20. Skokovic-Sunjic D. Clinical Guide to Probiotic Products Available in Canada [Internet]. AEProbio; 2023 [updated 2023 Jan; cited 2023 Jan 13]. Available from: https://probioticchart.ca/PBCIntroduction.html?utm_source=intro_pg&utm_medium=civ&utm_campaign=CDN_CHART 

December 22, 2022: Biosimilars and Drug Shortages

Read Now

https://mailchi.mp/usask.ca/medsask-newsletter-december-22-2022?e=[UNIQID]

Summary/Highlights

• The medSask newsletter is now posted on our website.
• Drug shortage updates: spironolactone, Estrogel® and antibiotic suspensions
• COVID-19 fall/winter booster program: updates to eligibility based on date of last dose
• Saskatchewan Biosimilars Initiative: biosimilar bookmarks
• Influenza prescribing guidelines: 8 minute video summarizing key points for antiviral prescribing
• From the medSask database
  • Carmen’s Resource Share: LactMed
  • Holiday hours
• Share your feedback with medSask! Help us create a valuable newsletter each month by completing a short (2-minute) survey.

References

1. medSask. medSask newsletter [Internet]. Saskatoon, SK; 2022 [cited 2022 Dec 15]. Available from: https://medsask.usask.ca/professional-practice/medsask-newsletter.php#RecentEditions
2. medSask. Drug Shortages and Discontinuations [Internet]. Saskatoon, SK; 2022 [cited 2022 Dec 15]. Available from: https://medsask.usask.ca/professional-practice/drug-shortages.php
3. Grindrod K, Barrett B, Killeen R. How to rethink Antibiotic Prescriptions. Pharmacy5in5. [Internet]. University of Waterloo; 2019 [2022 Dec 16]. Available from: https://uwaterloo.ca/pharmacy/sites/ca.pharmacy/files/uploads/files/ams-clinician-infographic_0.pdf
4. eHealth Saskatchewan. Biologic Products. Saskatchewan Immunization Manual. Government of Saskatchewan. [updated 2022 Dec; cited 15 Dec 2022] Available from: https://www.ehealthsask.ca/services/Manuals/Documents/sim-chapter10.pdf
5. Health Canada [Internet]. Ottawa, ON: Government of Canada. Biosimilar biologic drugs in Canada: Fact Sheet; 2019 [cited 2022 Dec 19]; [10 pages]. Available from: https://www.canada.ca/en/health-canada/services/drugs-health-products/biologics-radiopharmaceuticals-genetic-therapies/applications-submissions/guidance-documents/fact-sheet-biosimilars.html
6. Biosimilar Drugs: Your Questions Answered. [Internet]. Canada’s Drug and Health Technology Agency; 2021 April [cited 2022 Dec 15]. Available https://www.cadth.ca/sites/default/files/pdf/biosimilar_drugs_patient_tool.pdf
7. CDHFtube. IBD: Switching from a Biologic to a Biosimilar [video file]. 2021 March [cited 2022 Dec 15]. Available from: https://cdhf.ca/en/switching-from-a-biologic-to-a-biosimilar/
8. Arthritis Society Canada [Internet]. Toronto, ON: Arthritis Society Canada; 2022. Biologics and Biosimilars for the Treatment of Inflammatory Arthritis; [cited 2022 Dec 15]; [11 pages]. Available from: https://arthritis.ca/treatment/medication/biologics-and-biosimilars
9. Arthritis Research Canada. Biosimilars: What You Need to Know [video file]. 2021 May [cited 2022 Dec 19]. Available from: https://www.youtube.com/watch?v=TsK15BzXZEI
10. Mertens C, Rothblatt Z. Breaking Down Biosimilars [Internet]. Upper Nyack, NY: Global Health Living Foundation; 2021-2022 [cited 2022 Dec 19]. Available from: https://ghlf.org/breaking-down-biosimilars/
11. medSask. Influenza Minor Ailments Prescribing Guidelines [video file]. 21 Dec 2022. Accessed 22 Dec 2022. Available from: https://us06web.zoom.us/rec/play/CmYnoabl9MNm5k0oPEx530ODzVMJtSZVF9u67cJnzaRLLv7-5EpRkd9MzYj6PiPw8GuRfB91c-Grsffp.TTRvvhuyVUYAA5Ls?continueMode=true&_x_zm_rtaid=q3_7n1sZS4unVKdbEzcXLg.1671737322584.894243c5111446a86529fe36d2903238&_x_zm_rhtaid=274
12. Toxnet Toxicology Data Network.  Drugs and lactation database (LactMed) [homepage on the Internet].  Bethesda, MD: U.S. National Library of Medicine; 2016- [cited 2022 Dec 15].  Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/

December 9th: medSask Special Edition: Influenza

Read Now

https://mailchi.mp/usask.ca/medsask-special-edition-influenza?e=[UNIQID]

Summary/Highlights

• Oseltamivir Availability: update on supply and alternative administration
• Managing influenza symptoms at home 
• Co-infection: COVID-19? Influenza? or Both?
• How to use the Relenza (zanamivir) Diskhaler
• Key Points & Highlights from the Influenza Minor Ailment Guidelines

References

Influenza Newsletter – special edition. References are recorded in the order in which they appear. 

1. medSask. Influenza minor ailment guidelines. [Internet]. Saskatoon, SK; [updated Nov 2022; cited 6 Dec 2022]. Available from: https://medsask.usask.ca/professional-practice/restricted-guidelines/influenza.php
2. Bareham J, Regier L, Kosar L, et al. Medication Administration Challenges in Older Adults: To Crush or Not to Crush List. Geri-RxFiles. 3rd ed. Saskatoon, SK: University of Saskatchewan; 2019. p. 181-191.
3. CPS [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2021 [updated 2020 Feb 7; cited 2022 Dec 6]. Tamiflu [product monograph]. Available from: http://www.e-cps.ca or https://pdf.hres.ca/dpd_pm/00067405.PDF
4. At Home with COVID-19 or Influenza? [Internet].  medSask; 28 Nov 2022 [6 Dec 2022]. Available from: https://medsask.usask.ca/documents/covid-documents/managing-covid-19-flu-at-home.pdf
5. CPS [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2021 [cited 2022 Dec 6]. Available from: http://www.e-cps.ca or http://www.myrxtx.ca. Also available in paper copy from the publisher.
6. DynaMed [Internet]. Ipswich (MA): EBSCO Publishing. 1995 – 2012.[cited 2022 Dec 6]. Available from http://www.ebscohost.com/dynamed/. Registration and login required.
7. Up to Date [Internet]. Wolters Kluwer N.V. 2022. [cited 2022 Dec 6]. Available from: https://www.uptodate.com. Subscription required.
8. Playforth K. The Pediatrician Mom blog [Internet] Virginia: The Pediatrician Mom. 2022. [cited 2022 Dec 6]. Available from: https://www.thepediatricianmom.com/blog
9. Centers for Disease Control and Prevention [Internet]. Atlanta, GA. Similarities and Differences between Flu and COVID-19; 2022 Sept 28 [cited 2022 Dec 6]; [6 pages]. Available from: https://www.cdc.gov/flu/symptoms/flu-vs-covid19.htm#print
10. Relenza Prescribing Information. GSK Products [Internet]. GlaxoSmithKline; 2008 [updated 2021 October; cited 2022 Dec 6]. Available from: https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Relenza/pdf/RELENZA-PI-PIL-IFU.PDF
11. CPS [Internet]. Ottawa (ON): Canadian Pharmacists Association; c2021 [updated 2018 July 20; cited 2022 Dec 6]. Relenza [product monograph]. Available from: http://www.e-cps.ca or  https://pdf.hres.ca/dpd_pm/00046474.PDF
12. Medicines Org Uk. How to use your diskhaler [video file]. 2010 [cited 2022 Dec 6]. Available from: https://www.youtube.com/watch?v=wak2lw_4GjM
13. Influenza Q & A [internet]. Immunize Canada; 2022 [cited 2022 Dec 6]. Available from: https://immunize.ca/sites/default/files/Resource%20and%20Product%20Uploads%20(PDFs)/Campaigns/Influenza/2022-2023/influenza_q_and_a_2022_web_e.pdf

November 30th: Drug Shortages and Biosimilars

Read Now

https://mailchi.mp/usask.ca/medsask-newsletter-november-30th

Summary/Highlights

This edition of the newsletter covers the following content:

• Professional Practice
  • medSask drug shortage resources: amoxicillin, propranolol, Twinrix®Jr. and spironolactone
  • Using adult pain and fever medication in children and adolescents
  • Paxlovid™ expiry extension - UPDATED infographic to communicate adjusted expiry
• The Saskatchewan Biosimilars Initiative
• From the medSask database
  • Ozempic® for weight loss?
  • Kerrie’s Resource Share: Canadian Immunization Guide (CIG)
• Share your feedback with us! Help us create a valuable newsletter each month by completing a short survey. 

October 28th: Acetaminophen Shortage and Paxlovid

Read Now

https://mailchi.mp/usask.ca/medsask-newsletter-october-28-2022

Summary/Highlights

This edition of the newsletter covers the following content:

• Bivalent COVID-19 vaccines currently available in Saskatchewan 
  • Assessing for bivalent vaccine eligibility & confirming valid primary series 
• Options for influenza vaccine in 65+
• The Saskatchewan Biosimilars Initiative 
• Updating your Paxlovid™ prescribing/dispensing status with DPEBB
• Providing FREE take home naloxone kits within your pharmacy or practice site
• Acetaminophen Shortage Infographic QR Code Update 
• Translation services for medSask callers 
• From the medSask database 
  • Changes to Prevnar®13 availability – Update
  • Dorothy's resource share: Canadian ADHD Practice Guidelines

October 17th: Special Edition on Acetaminophen Shortage

Read Now

https://mailchi.mp/usask.ca/acetaminophen-shortage-tools-for-pharmacists

Summary/Highlights

This is a special edition of the medSask newsletter highlighting the Acetaminophen shortage and what pharmacists can and cannot do to manage the shortage. This edition of the newsletter covers the following content:

• Can pharmacists provide compounded acetaminophen suspension?
• Signage for your pharmacy (education for the general public)
• Offering alternatives to acetaminophen
• Key information about prescribing, compounding, and dispensing acetaminophen suspension.

September 29th: Spikevax™ and Influenza Resources

Read Now

https://mailchi.mp/usask.ca/medsask-newsletter-september-29-2022

Summary/Highlights

This edition of the newsletter covers the following content:

• Moderna Spikevax™ Bivalent as a booster dose in Saskatchewan
• Optimizing a vaccination appointment: giving COVID-19 booster dose with influenza vaccine 
• Influenza immunization resources
• Navigating the acetaminophen shortage 
• From the medSask database: Prevnar 20™ and doxepin for itch