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C: Adequate Drug Trials- 1. The minimum trial period for each preferred and step order drug is two weeks, unless otherwise stated within specific PDL drug categories; trials with less than a two week duration will be reviewed on a case-by-case basis; 2. A trial will not be considered valid if preferred or non-preferred products were readily available by override, individual purchase, samples, etc. 3. Certain drug trials, such as with controlled substances, may require evidence that the preferred drugs were actually tried example: with random pill counts and with urine drug tests, using methods of GC MS with no lower threshold 4. Adequate trials require documentation of attempts to titrate dose of preferred agents toward desired clinical response. 5. Adequate trials include prevention treatment of common adverse effects associated with preferred agents example: antinausea, antipruritics, etc. ; D: Step Order- When numbers appear in the "step order" column, it means drugs in this category must be used in the order specified, with the lower numbers having preference over the higher numbers. Chart notes should be provided to confirm drug trials that do not appear in the member's MaineCare drug profile. E: Brand Name Medication Requests- Must be submitted on the Brand Name PA request form ; - According to MaineCare Benefits Manual Chapter II 80.07-5 ; , when medically necessary covered brand-name drugs have an A-rated generic equivalent available, the most cost effective medically necessary version will be approved and reimbursed, since the brand-name and A-rated generic drugs have been determined by the FDA to be chemically and therapeutically equivalent. The Bureau does not make determinations as to whether or not a generic drug is clinically inferior or inequivalent to its brand version. This is the proper role of the FDA. Physicians should submit their reports of generic inequivalence directly to the FDA via the MEDWATCH. F: PA requests for non- FDA Approved Indications- Decisions will be made on a case-by-case basis until the DUR committee is able to review the evidence and make a recommendation. Interim approvals and DUR recommendations for approval of a drug for a non- FDA approved indication will require a minimum of two published, peer reviewed, non contradicted, double- blind, placebo-controlled randomized clinical studies establishing both safety and efficacy. G: Dose Consolidation Requirements- Some drugs may also be affected by dose consolidation requirements. Please see Dose Consolidation List and or Splitting Tables provided in the PDL. H. Trials from Multiple Drug Classes - Trial failure intolerance to preferred agents from multiple classes within the same category or other catagories of drugs may be required prior to the approval of non-preferred agents e.g., Cymbalta, Zofran, Elidel and others ; . J. Drug-specific PA Forms- Drug-specific PA forms contain medical necessity documentation requirements and or criteria that may not be repeated in the PDL. Drug-specific PA forms may be obtained on the web at mainecarepdl . K. PA Exemptions for Prescribers- According to MaineCare Benefits Manual Chapter II 80.07-4 ; , providers may receive a three 3 ; month exemption from prior authorization requirement for certain categories of drugs when they demonstrate high compliance with the Department's PDL. The Department will notify providers in writing which drug categories are included and what dates apply to the exemption. If a provider loses his her exemption, members who previously were not required to obtain a PA while the prescriber was exempt will be required to do so, and criteria for approval of that medication will need to be met. L: Drug-Drug Interactions DDI ; -The DUR Committee has implemented new drug-drug interation edits requiring prior authorization. Several drug-drug combinations and PDL drug catagories are affected by new PA requirements. These will be indicated in the PDL with DDI notation. Please see the DDI document provided in the PDL. ASSORTED ANTIBIOTICS BETA-LACTAMS CLAVULANATE COMBO'S AMOXICILLIN AMOXICILLIN POTASSIUM CLA CHEW AMOXICILLIN POTASSIUM CLA SUSR AMOXICILLIN POTASSIUM CLA TABS AMOXIL1 AMPICILLIN AUGMENTIN XR TB12 BEEPEN BICILLIN L-A SUSP DICLOXACILLIN SODIUM CAPS DYNAPEN SUSR GEOCILLIN TABS OXACILLIN SODIUM SOLR PENICILLIN V POTASSIUM TICAR SOLR TIMENTIN SOLR TRIMOX UNASYN SOLR VEETIDS ZOSYN CEPHALOSPORINS CEFADROXIL HEMIHYDRATE CEFAZOLIN SODIUM SOLR CEDAX CEFUROXIME AXETIL TABS CEFACLOR1 CECLOR1 1. Both brand and generic are clinically nonpreferred. Use PA Form # 20420 AMOXIL 500mg TABS AUGMENTIN 3 PRINCIPEN CAPS 2 PRINCIPEN SUSR AUGMENTIN ES-600 SUSR 1. Amoxli 500mg tabs are non-preferred. All other Amoxill products are preferred. 2.Principen 250 mg is available without PA. 3. Chewable 125mg & 250mg and Solution 125mg 5ml and 250mg 5ml available without PA and noroxin.
Have you ever noticed that almost every concept or device that is permanently attached to an adjective becomes degraded and devalued? Like organic agriculture, sustainable development, participatory breeding, alternative technology, protected democracy, market economy. Traditional knowledge is no exception. Traditional knowledge is knowledge, just like mathematics, biology or sociology. What makes it distinct is that it has been carefully and patiently created, built, nourished, circulated and promoted by common, non-powerful people: small farmers, fisherfolk, hunter-gatherers, traditional healers, midwives, artisans, traditional poets, and many others. Because the majority of these people belong to rural cultures or have close links with rural cultures, such knowledge is intimately linked to the understanding of natural processes. It is a form of knowledge that is continuously evolving, integrating new knowledge into a rich pool that has been tested and enriched over centuries. We don't go around talking of "mathematical knowledge" or "sociological knowledge". The reason we always hear about "traditional knowledge" is that this way we can diminish a form of knowledge that. Zaccaria A, 1 Gugliotta L, 2 Valenti A, 1 Franchi F, 4 La Starza R, 3 Testoni N, 5 Tascedda T, 4 Salvucci M, 3 Tieghi A, 2 Bulgarelli S, 2 Vianelli N, 5 Croci G, 4 Mecucci C3 1 Hematology Unit, Ravenna; 2Hematology Unit, Reggio Emilia; 3 Hematology Unit, Perugia; 4Genetics Unit, Reggio Emilia; 5 Hematology Unit, Bologna, Italy The Essential Thrombocythaemia ET ; diagnosis is fundamentally done by excluding the secondary thrombocytosis, the other chronic Myeloproliferative Disorders MPD ; and the Myelodysplastic Syndromes MDS ; . According to the PVSG diagnostic criteria, the cytogenetic study is primarily required to document the absence of the Ph chromosome, although today it is more convenient and cheaper to exclude the Cml diagnosis by the documentation of the bcr-abl transcript absence. Moreover, the cytogenetic study, particularly when integrated with molecular techniques, is very useful to discriminate the ET from the MDS with thrombocytosis and, in general, to identify genetic abnormalities with potential prognostic value. In the old series of patients of the Registro Italiano Trombocitemia RIT ; the cytogenetic study at diagnosis was available and valuable in 958 44.8% ; of the 2139 cases. In 47 patients 4.9% ; were reported aspecific abnormalities that now are object of a centralised evaluation by the Genetics Committee of the RIT. Concomitantly, the cytogenetic data of the ET patients consecutively observed in the Haematological Centres of Ravenna, Reggio Emilia and Perugia are object of the centralised evaluation. In the series of Ravenna 65 patients, 25 males, 40 females, median age 60 yrs ; aspecific cytogenetic abnormalities were documented in height cases 12, 7% ; : 46, XO, -Y; 46, XY, der 20 ; t 1; 20 ; q21; q13 46, XY, t 5; 11. Note: In pregnancy: Augmentin as above plus Erythromycin ethyl succinate EES ; 400mg 6 hourly p.o. for 14 days. Ceftriaxone 1 gram can be used as stat doses in the treatment of gonorrhoea Ciprafloxacin 500mg needs specialist recommendation ; May require prolonged course of antibiotics: Augmentin; or Amozil and metronidazole instead of augmentin Unresponsive to treatment refer Category 1 and prograf! Acetaminophen. 1 Acetaminophen with Codeine . 1 Acetylsalicylic Acid, ASA. 4 Actifed. 61 Acyclovir . 1 Adalat. 41 Adrenalin. 18 Albalon. 40 Albalon-A . 40 Albuterol . 2 Aldactone . 56 Allopurinol. 2 Alprazolam . 2 Aluminum Hydroxide and Magnesium Hydroxide . 2 Amantadine . 2 Amitriptyline . 3 Ammonia Spirit, Aromatic Inhalant . 3 Amoxicillin. 3 Xmoxil . 3 Antipyrine w Benzocaine Otic Solution . 3 Antivert . 36 Aplisol. 61 Aristocort . 60 Artane. 60 Ascorbic Acid . 4 Aspirin. 4 Atenolol . 5 Ativan. 34 Atropine Sulfate . 5 Atrovent . 29 Auralgan. 3 Azulfidine . 56.
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