You are correct. According to a recent article in Pediatrics, the top 10 drugs implicated in drug interactions in pediatric patients covered by Medicaid in the outpatient setting were:

1. clonidine hydrochloride
2. trazadone hydrochloride
3. montelukast sodium
4. fluticasone propionate
5. amphetamine salt combination
6. risperidone
7. lisdexamfetamine dimesylate
8. hydroxyzine hydrochloride
9. aripiprazole
10. cetirizine hydrochloride

Source:
Kyler K, et al. (2024, January 4). Pediatrics. Major Drug-Drug Interaction Exposure Among Medicaid-Insured Children in the Outpatient Setting.

You are correct. The first 10 drugs to be negotiated by Medicare were selected because they account for a significant portion of Medicare Part D spending. Cosentyx is not on that list.

Here are the 10 drugs:

1. Eliquis (apixaban)
2. Entresto (sacubitril/valsartan)
3. Xarelto (rivaroxaban)
4. Januvia (sitagliptin)
5. Jardiance (empagliflozin)
6. Farxiga (dapagliflozin)
7. Novolog FlexPen (insulin aspart)
8. Imbruvica (ibrutinib)
9. Enbrel (etanercept)
10. Stelara (ustekinumab)

Source: (2024, January 4). The Commonwealth Fund. How Prices for the First 10 Drugs Up for U.S. Medicare Price Negotiations Compare Internationally

You are correct. Febuxostat is a xanthine oxidase inhibitor indicated for gout prophylaxis in adults.

As a reminder, you can use the Pill ID feature to identify a pill based on its imprint code or physical characteristics, including shape, color, and scoring. Find Pill ID in the epocrates app or on epocrates Web.

You are correct. COVID-19 was the most deadly infectious disease in 2022, followed by tuberculosis, according to a Statista report which used World Health Organization data to determine the global deaths for four infectious diseases in 2022.

Here are the top four infectious disease by number of deaths:

1. COVID-19: 1.24 million

2. Tuberculosis: 1.13 million

3. HIV/AIDS: 630,000
(Deaths from TB among people with HIV officially classified as deaths from HIV/AIDS.)

4. Malaria: 620,000
(2021 data)

Source: Taylor, M. (2023, November 8). Becker's Hospital Review. Clinical Leadership. The world's deadliest infectious diseases.

You are correct. Banophen (diphenhydramine) is an antihistamine used for relieving allergic rhinitis, sneezing, hives, itchy/watery eyes, itchy nose/throat/skin; promoting sleep; and preventing motion sickness.

As a reminder, you can use the Pill ID feature to identify a pill based on its imprint code or physical characteristics, including shape, color, and scoring. Find Pill ID in the epocrates app or on epocrates Web.

You are correct. Ritonavir-boosted atazanavir can increase vinblastine levels through inhibition of CYP3A4, which may have contributed to increased risk of neutropenia in this pt. In addition, higher vinblastine levels may have enhanced inhibition of the MRP2 (multidrug resistance-associated protein 2) transporter in the proximal renal tubule, increasing renal toxicity from tenofovir disoproxil, thereby causing hypokalemia. When ritonavir-boosted atazanavir was replaced w/ dolutegravir during subsequent ABVD cycles, no further hypokalemia or neutropenia were observed.

Source article: Cordova E, Morganti L, Odzak A, et al. Severe hypokalemia due to a possible drug-drug interaction between vinblastine and antiretrovirals in [an] HIV-infected patient with Hodgkin’s lymphoma. Int J STD AIDS. 2017 Oct;28(12):1259-1262. doi: 10.1177/0956462417703026.

More info is available in the Int J STD AIDS abstract in PubMed.