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Articles 4681 - 4710 of 9501

Full-Text Articles in Medicine and Health Sciences

Trametinib And Dabrafenib: New Agents For Advanced Stage Melanoma, Kelsey Weisenburger, Kevin Krivanek, Armond Cosiano, Kasie Bellmann, Mark E. Olah Oct 2019

Trametinib And Dabrafenib: New Agents For Advanced Stage Melanoma, Kelsey Weisenburger, Kevin Krivanek, Armond Cosiano, Kasie Bellmann, Mark E. Olah

Pharmacy and Wellness Review

Melanoma, the deadliest form of skin cancer, is caused primarily by exposure to ultraviolet radiation. Tumor formation occurs early in disease progression and can easily metastasize. The development of the disease can be described by one of four stages, characterized by tumor size and risk of spreading. The B-rafprotein plays an important role in cell proliferation and has the ability to develop a mutation for continuous activation, resulting in uncontrolled cell growth. Sixty percent of melanomas possess a V600E mutation in the BRAF gene. Recently, drug developers have turned the focus of melanoma treatments toward preventing the activation of the …


Phenoconversion: Drug-Drug-Gene Interactions, Molly Kulp, Emily Limberg, Brooke Marlowe, Taylor Roberson, David F. Kisor Oct 2019

Phenoconversion: Drug-Drug-Gene Interactions, Molly Kulp, Emily Limberg, Brooke Marlowe, Taylor Roberson, David F. Kisor

Pharmacy and Wellness Review

Based on the extensive, poor, intermediate and ultrarapid phenotypes of patients, inferences may be made relative to drug metabolism, ultimately leading to changes in therapeutic drug choice or dosing. Phenoconversion is a phenomenon that occurs when an individual's drug metabolizing capacity is altered due to the combination of a drug-drug interaction and a drug-gene interaction. Phenoconversion can affect pharmacokinetics as well as pharmacodynamics. Some examples of phenoconversions include amiodarone-warfarin, duloxetine-codeine, rifampin-clopidogrel, and rifampinwarfarin. Pharmacists must consider phenoconversion in cases of multi-drug therapy.


A Review Of The Guidelines And Treatment Options For Major Depressive Disorder In Adolescents, Stacy Henthorne, Joy Hoffman, Albert Bui, Sarah Kradel, Suzanne M. Lifer, Mary Ellen Hethcox Oct 2019

A Review Of The Guidelines And Treatment Options For Major Depressive Disorder In Adolescents, Stacy Henthorne, Joy Hoffman, Albert Bui, Sarah Kradel, Suzanne M. Lifer, Mary Ellen Hethcox

Pharmacy and Wellness Review

Major depressive disorder (MOD) is a disease often underdiagnosed in adolescents. For adolescents in particular, MOD can have far-reaching implications on developmental, social and emotional functioning. Unfortunately, few guidelines detail consistent means by which to evaluate and treat these patients; significantly more information exists that solely pertains to the adult population. Governing bodies such as the American Academy of Child and Adolescent Psychiatry (AACAP) and Resource for Advancing Children's Health (REACH) recommend that primary care physicians be diligent in their psychiatric analyses and follow-ups with young patients who may be experiencing MOD. Both psychotherapy and medications, either as monotherapy or …


Answers About The Need For Vitamin D Supplementation, Halle Orlinski, Hannah Stewart, Amanda Lanker, Sarah Kradel, Sandra L. Hrometz Oct 2019

Answers About The Need For Vitamin D Supplementation, Halle Orlinski, Hannah Stewart, Amanda Lanker, Sarah Kradel, Sandra L. Hrometz

Pharmacy and Wellness Review

Vitamin D has a significant role in bone health, calcium homeostasis, immune function and other biological functions. In our bodies, the main source of vitamin D is linked to our skin's exposure to sunlight. It can also be obtained through foods that contain vitamin D. Despite these two sources, vitamin D supplementation is often necessary. It is available in two forms, cholecalciferol and ergocalciferol as over-the-counter (OTC) products, as well as calcitriol as prescription only. Reasons for vitamin D deficiency include lack of sunlight, poor diet, malabsorption of vitamin D, liver and/or kidney disease. Vitamin D deficiencies lead to diseases …


Achieving Provider Status For Pharmacists, Kasie Bellmann, Alexandra Dimit, Kelsey Weisenburger, Donald L. Sullivan Oct 2019

Achieving Provider Status For Pharmacists, Kasie Bellmann, Alexandra Dimit, Kelsey Weisenburger, Donald L. Sullivan

Pharmacy and Wellness Review

In order to receive payment for medical services through Medicare Part 8, health care professionals must be identified as "providers" under the Social Security Act. Pharmacists currently are not included in the list of providers and, therefore, cannot provide many services to patients. Through their extensive education and training, accessibility and immense trust in their profession, pharmacists are the ideal health care professionals to help expand the continuity of care of our nation's patients. On Jan. 1, 2014, Senate Bill 493 was passed into law recognizing pharmacists in the state of California as providers. With this new legislation, the pharmacists' …


Neonatal Abstinence Syndrome: A Targeted Review For Pharmacists, Andrew Skouby, Gabi Gegenheimer, Kelsey Lindsley, Sarah Kradel, Michael Rush Oct 2019

Neonatal Abstinence Syndrome: A Targeted Review For Pharmacists, Andrew Skouby, Gabi Gegenheimer, Kelsey Lindsley, Sarah Kradel, Michael Rush

Pharmacy and Wellness Review

Neonatal abstinence syndrome (NAS) is a disease that impacts drug-exposed infants and describes an array of issues that arise in newborns just hours after birth. Patient presentation and disease symptomatology vary widely based upon the specific substance utilized by the mother while pregnant and duration of exposure. Treatment is dependent on which symptoms are present and, assuming an opioid-derived abstinence syndrome, is based primarily on opioid supplementation to prevent symptoms of withdrawal. Treatment of non-opioid derived abstinence syndrome is often slightly more complex and involves the use of different agents depending on the drug of exposure. Due to the intricate …


Medication Overdoses In The Emergency Department: Oral Hypoglycemic Agents, Atypical Antipsychotic Agents, Beta-Blockers, Calcium Channel Blockers, And Digoxin, Brooke Marlowe, Tara Tokar, Kayti Kintner, Kelsey Fink, Grant Walliser Oct 2019

Medication Overdoses In The Emergency Department: Oral Hypoglycemic Agents, Atypical Antipsychotic Agents, Beta-Blockers, Calcium Channel Blockers, And Digoxin, Brooke Marlowe, Tara Tokar, Kayti Kintner, Kelsey Fink, Grant Walliser

Pharmacy and Wellness Review

The number of medication toxicities has been steadily increasing with more patients presenting to the emergency department for both intentional and unintentional overdoses. Oral hypoglycemics, atypical antipsychotics, betablockers, calcium channel blockers and digoxin overdoses are some of the more common medication toxicities health care professionals may see in practice. Toxic doses of oral hypoglycemic agents, beta-blockers, calcium channel blockers and digoxin have more definitive options for treatment, while atypical antipsychotic overdoses are managed with supportive care. Pharmacists in particular play a pivotal role in identifying presenting symptoms and recommending appropriate treatment options in toxicological emergencies.


Legislation Editorial, Kent Wilin, Kaitlin Horton, Maria Laikos Oct 2019

Legislation Editorial, Kent Wilin, Kaitlin Horton, Maria Laikos

Pharmacy and Wellness Review

No abstract provided.


Whooping Cough: A Pharmacist's Role In An Emerging Endemic, Haley Armstrong, Lydia Suchecki, Sarah Lipperman, Taylor Roberson, Andrew M. Roecker Oct 2019

Whooping Cough: A Pharmacist's Role In An Emerging Endemic, Haley Armstrong, Lydia Suchecki, Sarah Lipperman, Taylor Roberson, Andrew M. Roecker

Pharmacy and Wellness Review

Pertussis is an acute infectious disease caused by the organism Bordetella pertussis and characterized by a "whooping cough." Incidence of the disease had declined since the development of a vaccine, but is now increasing in reported cases. This increase has been attributed to both an increased awareness but also surmised to be related to a decrease in vaccinations. The pertussis vaccine is given in conjunction with tetanus and diphtheria vaccines to children before the age of 6 in five separate injections over the course of four to six years. A booster is now recommended for the older child and adults …


The Safety Of Artificial Sweeteners And Their Use In Pharmaceuticals, Kaila Bollinger, Maureen Moynihan, Adam Smith, Alison Steinbrunner, Karen Kier Oct 2019

The Safety Of Artificial Sweeteners And Their Use In Pharmaceuticals, Kaila Bollinger, Maureen Moynihan, Adam Smith, Alison Steinbrunner, Karen Kier

Pharmacy and Wellness Review

Artificial sweeteners are sugar substitutes that add sweetness to foods and beverages without the extra calories found in sugar. These additives are used to help patients with diabetes avoid hyperglycemia and assist people in losing weight or avoiding weight gain by providing a replacement to higher calorie sugar-sweetened foods. Artificial sweeteners can be found in many sugar-free beverages, candies and gum, as well as pharmaceutical products. Although artificial sweeteners are often recommended over the sugar-sweetened alternatives in weight loss and diabetes prevention, the use of such products are not without risk. Studies have been conducted to assess artificial sweeteners involvement …


Overview Of Kalydeco® (Ivacaftor) For Treatment Of Cystic Fibrosis, Andrew Skouby, Kayti Kintner, Kimberly Loughlin, Emily Blum, Michael Rush Oct 2019

Overview Of Kalydeco® (Ivacaftor) For Treatment Of Cystic Fibrosis, Andrew Skouby, Kayti Kintner, Kimberly Loughlin, Emily Blum, Michael Rush

Pharmacy and Wellness Review

Cystic fibrosis (CF) is a genetic disease associated with specific gene mutations that presents with pulmonary inflammation and frequent lung infections, exocrine pancreatic insufficiency, altered sweat composition and declining lung function. Ivacaftor (Kalydeco®) was approved for treatment of cystic fibrosis in patients 6 years of age and older with a G551D mutation on the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Ivacaftor is a CFTR potentiator and does not work in patients with a mutation of the F508del. Efficacy has been demonstrated in several trials with a primary outcome of improved FEV1, improvements in pulmonary exacerbations, patient-reported decrease in respiratory …


Evidence For The Potential Use Of Polyphenols And Their Derivatives In Moderating Allergic Immune Responses, Jamie Kellner, Lindsay Mark, Kasie Bellmann, Kelly Shields Oct 2019

Evidence For The Potential Use Of Polyphenols And Their Derivatives In Moderating Allergic Immune Responses, Jamie Kellner, Lindsay Mark, Kasie Bellmann, Kelly Shields

Pharmacy and Wellness Review

Polyphenols are naturally occurring compounds that are found within numerous plant sources. They have a wide variety of structures and functions and have potential clinical uses in multiple disease states. Emerging studies involving polyphenols have demonstrated their antioxidative properties, as well as reduced risks of cardiovascular diseases and certain types of cancer. Due to these discoveries, there has been a marked increase in research related to the chemical properties of polyphenols and their potential uses in prevention of common acquired and inherited disease states. This article focuses on the effects that some polyphenolic compounds exert on immune function in regard …


Emergency Contraception: A Comparison Of Levonorgestrel And Ulipristal Acetate, Tara Tokar, Rachel Muhlenkamp, Kelsey Lindsley, Alison Steinbrunner, Michelle Musser Oct 2019

Emergency Contraception: A Comparison Of Levonorgestrel And Ulipristal Acetate, Tara Tokar, Rachel Muhlenkamp, Kelsey Lindsley, Alison Steinbrunner, Michelle Musser

Pharmacy and Wellness Review

Emergency contraceptives (EC) are a birth control method that is available to minimize unintended pregnancies that might result from unprotected intercourse. Several products are on the market and largely contain levonorgestrel as the active component, including Plan B One-Step®, Next Choice®, Next Choice One Dose™ and My Way®. These are labeled as effective up to 72 hours after intercourse and are available without a prescription. Another product, Ella™, contains ulipristal acetate and can be effective up to 120 hours after intercourse, but does require a prescription. Legislative issues have surrounded these products. At this point in time only Plan B …


Drugs Of Abuse: A Review Of Tramadol Abuse, Brittany Crowe, Tiffany Kneuss, Benjamin Finley, Kelsey Fink, Manoranjan S. D'Souza Oct 2019

Drugs Of Abuse: A Review Of Tramadol Abuse, Brittany Crowe, Tiffany Kneuss, Benjamin Finley, Kelsey Fink, Manoranjan S. D'Souza

Pharmacy and Wellness Review

Prescription drug abuse is the fastest growing drug problem in America. Among the different prescription drugs being abused, analgesics are the most commonly abused group of drugs. In the last few years, there is increasing evidence of abuse of tramadol, which is an atypical, centrally acting opioid analgesic. The increasing abuse of tramadol has prompted regulatory authorities to strengthen the product labeling of tramadol with respect to its abuse potential. Furthermore, several states have added tramadol to their controlled substances list. In this article, we will review the pharmacology of tramadol and some of the preclinical and clinical studies that …


Celiac Disease: Current And Investigational Therapies And The Role Of The Pharmacist, Sarah Turley, Gabriella Gegenheimer, Emily Blum, Erin Petersen Oct 2019

Celiac Disease: Current And Investigational Therapies And The Role Of The Pharmacist, Sarah Turley, Gabriella Gegenheimer, Emily Blum, Erin Petersen

Pharmacy and Wellness Review

Celiac disease is a genetically-linked autoimmune disease which affects the gastrointestinal tract. It is an inflammatory reaction to ingested gluten-containing substances that produces the most frequent symptoms of abdominal pain, bloating and intermittent or chronic diarrhea. Diagnosis can be made by blood testing for specific IgA autoantibodies and a confirmation duodenal biopsy to look for the characteristic scalloping and villous atrophy that occurs in response to the inflammation. A gluten-free diet, until recently, was the only treatment available and continues to be the mainstay of treatment. Newer adjunct therapies to dietary management include larazotide acetate, peptidases, the use of parasite …


A Comparison Of Mipomersen (Kynamro®) And Lomitapide (Juxtapid®): Medications For The Treatment Of Homozygous Familial Hypercholesterolemia, Ann Marie Ruhe, Austin Brown, Ginny Daniels, Kelsey Fink, David Bright Oct 2019

A Comparison Of Mipomersen (Kynamro®) And Lomitapide (Juxtapid®): Medications For The Treatment Of Homozygous Familial Hypercholesterolemia, Ann Marie Ruhe, Austin Brown, Ginny Daniels, Kelsey Fink, David Bright

Pharmacy and Wellness Review

Homozygous familial hypercholesterolemia (HoFH) is a rare disease that involves mutations in the genes coding for low density lipoprotein (LDL) receptors, preventing the uptake of LDL cholesterol from the serum and resulting in extremely high cholesterol levels.1 Between December 2012, and January 2013, two orphan drugs were approved by the U.S. Food and Drug Administration (FDA) for the treatment of HoFH. Mipomersen (Kynamro®) is a subcutaneous injection that functions as an antisense oligonucleotide inhibitor and ultimately prevents the translation of mRNA coding for apolipoprotein B (apoB)-100 which binds to LDL and very low density lipoprotein (vLDL) cholesterol.7 Lomitapide (Juxtapid®) is …


Signifor® Receives Fda Approvalfor The Management Of Cushing's Disease, Justin Steele, Ann Marie Ruhe, Andrew Skouby, Eric Stack, Sandra L. Hrometz Oct 2019

Signifor® Receives Fda Approvalfor The Management Of Cushing's Disease, Justin Steele, Ann Marie Ruhe, Andrew Skouby, Eric Stack, Sandra L. Hrometz

Pharmacy and Wellness Review

Cushing's disease is a disorder characterized by supraphysiologic levels of circulating cortisol due to excessive adrenocorticotropic hormone (ACTH) secretion. Most often hypersecretion of ACTH is due to a pituitary adenoma, where surgical resection of the tumor is considered first-line treatment for the disease. Alternatively, the FDA has recently approved the somatostatin analogue, Signifor® (pasireotide), for the management of Cushing's disease in patients for whom surgery is not an option. In clinical trials, pasireotide has shown a statistically significant reduction in urinary free cortisol levels, as well as significant improvements in quality of life. Based on current data, pasireotide appears to …


Ado-Trastuzumab Emtansine For Her2 Positive Breast Cancer, Kimberly Baucher, Taylor Beale, Maria Laikos, Eric Stack, Mary Ellen Hethcox Oct 2019

Ado-Trastuzumab Emtansine For Her2 Positive Breast Cancer, Kimberly Baucher, Taylor Beale, Maria Laikos, Eric Stack, Mary Ellen Hethcox

Pharmacy and Wellness Review

No abstract provided.


Novel Oral Anticoagulants: A Comparative Study Of The Clinical Potential For Dabigatran, Rivaroxaban, And Apixaban Versus Warfarin, Lindsay Mark, Joanne Tran, Zachary Jones, Jessica Beck, David Bright Oct 2019

Novel Oral Anticoagulants: A Comparative Study Of The Clinical Potential For Dabigatran, Rivaroxaban, And Apixaban Versus Warfarin, Lindsay Mark, Joanne Tran, Zachary Jones, Jessica Beck, David Bright

Pharmacy and Wellness Review

Although Coumadin® (warfarin) has been the standard outpatient anticoagulant for long-term prevention of thrombosis for many decades, it presents with significant challenges for both patients and health care providers in optimizing standards of care including dietary and drug restrictions, regular monitoring of the patient's International Normalized Ratio (INR), and difficulty maintaining therapeutic levels. Despite its unmistakable effectiveness, there has been an interest from the medical community in developing potential alternative drug therapies. As a result, within the past three years the U.S. Food and Drug Administration (FDA) has approved the use of three new oral anticoagulant drugs (dabigatran, rivaroxaban, and …


Understanding The Pharmacokinetic Interaction Between Alcohol And Long-Acting Opioids, Emily Blum, Brittany Crowe, Tanya Wilsmann, Heather Helsel, David Kisor Oct 2019

Understanding The Pharmacokinetic Interaction Between Alcohol And Long-Acting Opioids, Emily Blum, Brittany Crowe, Tanya Wilsmann, Heather Helsel, David Kisor

Pharmacy and Wellness Review

In response to the fatal interaction of alcohol with extended-release hydromorphone, the U.S. Food and Drug Administration (FDA) approved a class-wide Risk Evaluation and Mitigation Strategy (REMS) for extended-release (ER) and long-acting (LA) opioid analgesics in July 2012. Due to the rising concern of dose-dumping effects, it is important for pharmacists to understand the pharmacokinetic interaction between two of the most commonly prescribed LA opioids (oxycodone and morphine) and alcohol. Clinical trials have looked at the pharmacokinetic profile of these long-acting formulations in conjunction with alcohol, and the results have varied depending on the formulation. For this reason, it is …


Antidepressant Therapy: A Review Of Current Treatment Options And A Glance At The Future, Brittany Dye, Stacy Henthorne, Molly Kulp, Tristan Maiers, Zachary Crawford, Erin Petersen Oct 2019

Antidepressant Therapy: A Review Of Current Treatment Options And A Glance At The Future, Brittany Dye, Stacy Henthorne, Molly Kulp, Tristan Maiers, Zachary Crawford, Erin Petersen

Pharmacy and Wellness Review

Depression and anxiety disorders are two of the most common mental illnesses experienced by people within the United States, affecting 6.7 percent of the adult population per year. This article will focus on one specific type of depression, major depressive disorder (MDD), characterized by two or more weeks of depressed mood and/or decreased interest in normally enjoyed activities. Depression complicates treatment of other disease state(s), making successful treatment of depression essential in the management of a patient's overall health. This review will evaluate the pathophysiology, antidepressant treatment, and new approaches to treatment, specifically vortioxetine, for MDD.


Makena®: A Drug For Reducing The Risk Of Preterm Labor, Amanda Lovell, Kasie Bellman, Kelsey Fink, Jessica Beck, Michelle Musser Oct 2019

Makena®: A Drug For Reducing The Risk Of Preterm Labor, Amanda Lovell, Kasie Bellman, Kelsey Fink, Jessica Beck, Michelle Musser

Pharmacy and Wellness Review

Makena®, hydroxyprogesterone caproate, is an intramuscular injection that is U.S. Food and Drug Administration (FDA) approved to reduce the risk of preterm delivery before 37 weeks of pregnancy in pregnant women with a history of spontaneous preterm birth, who are not currently carrying multiple children. One in nine babies born in the United States each year is born prematurely, or before 37 weeks gestation, and mothers who have previously delivered a premature baby are 2.5 times more likely to deliver another baby prematurely. Makena® is administered by a health care professional as a single intramuscular injection to the hip and …


Fda Approves New Tuberculosis Drug: Bedaquiline (Sirturo®), Megan Ruffner, Kent Wilin, Charles Hay, Zachary Crawford, Andrew Roecker Oct 2019

Fda Approves New Tuberculosis Drug: Bedaquiline (Sirturo®), Megan Ruffner, Kent Wilin, Charles Hay, Zachary Crawford, Andrew Roecker

Pharmacy and Wellness Review

Tuberculosis (TB), caused by the acid-fast bacilli (AFB) Mycobacterium tuberculosis, is an infectious disease that continues to greatly impact morbidity and mortality worldwide; in 2011 it caused 1.4 million deaths. Some strains of the bacteria have become resistant to current treatment regimens, resulting in multidrug-resistant (MOR) and extensively drugresistant (XOR) TB. The emergence of these resistant strains of bacteria calls for new treatment regimens that can quickly and effectively eradicate the organism. The U.S. Food and Drug Administration (FDA) recently approved Sirturo® (bedaquiline) with the indication of MDR pulmonary TB. Bedaquiline introduces a novel mechanism of action via the inhibition …


Endometriosis: The Etiology And Recommended Treatment, Amanda Lovell, Kasie Bellmann, Kelsey Fink, Jessica Beck, Michelle Musser Oct 2019

Endometriosis: The Etiology And Recommended Treatment, Amanda Lovell, Kasie Bellmann, Kelsey Fink, Jessica Beck, Michelle Musser

Pharmacy and Wellness Review

Endometriosis is a gynecological condition that occurs in women between the ages of 15 and 49 years, in which endometrial cells grow outside the uterus. Normally, endometrial cells form the endometrium and respond to hormones throughout the menstrual cycle, but when endometrial cells are located outside the endometrium, painful bleeding and other side effects may occur. Treatment of endometriosis is usually symptomatic relief, including the use of oral contraceptives and other hormone replacement options, as well as non-steroidal anti-inflammatory drugs. To ensure that patients receive the appropriate treatment for this condition, pharmacists should be able to recognize the signs and …


Immunization Guidelines For Pregnant Women, Kelly Dye, Maria Laikos, Tristan Maiers, Eric Stack, Natalie Dipietro Oct 2019

Immunization Guidelines For Pregnant Women, Kelly Dye, Maria Laikos, Tristan Maiers, Eric Stack, Natalie Dipietro

Pharmacy and Wellness Review

There are many misconceptions among the general public regarding the administration of vaccinations during pregnancy. It is imperative for pharmacists to be current regarding guidelines and updates about recommended vaccines. Data from the Centers for Disease Control and Prevention (CDC) indicate that while some vaccines are highly recommended during pregnancy, others have limited safety data or are contraindicated. As new data emerges on the safety and efficacy of immunizations during pregnancy, pharmacists should continue to review the literature to stay up-to-date on vaccination recommendations. The CDC also has information available for pharmacists and other health care professionals regarding the use …


Truvada® Recommended By Fda Committee For Pre-Exposure Prophylaxis In High-Risk Hiv-Negative Individuals, Justin Steele, Emily Blum, Alison Steinbrunner, Lara Long, Andrew M. Roecker Oct 2019

Truvada® Recommended By Fda Committee For Pre-Exposure Prophylaxis In High-Risk Hiv-Negative Individuals, Justin Steele, Emily Blum, Alison Steinbrunner, Lara Long, Andrew M. Roecker

Pharmacy and Wellness Review

Once-daily combination tenofofovir disoproxil fumarate (TDF) and emtricitabine (FTC) has received Food and Drug Administration (FDA) approval for use in pre-exposure prophylaxis (PrEP) against Human Immunodeficiency Virus (HIV) infection in high-risk individuals. In clinical trials, FTC/TDF has been shown to reduce the risk of HIV acquisition by 62 percent in sexually active heterosexual men and women. Similarly, use of FTC/TDF demonstrated a 44 percent reduction in HIV infection within the men who have sex with men population.7 When used compliantly and in conjunction with safe sex practices, it appears that FTC/TDF can play an important role in reducing the …


Comparing The Glp-1 Receptor Agonists: Byetta®, Victoza® And Once-Weekly Bydureon™, Todd A. Tucker Jr., Sarah Turley, Kaila Bollinger, Jessica Beck, Sandra L. Hrometz Oct 2019

Comparing The Glp-1 Receptor Agonists: Byetta®, Victoza® And Once-Weekly Bydureon™, Todd A. Tucker Jr., Sarah Turley, Kaila Bollinger, Jessica Beck, Sandra L. Hrometz

Pharmacy and Wellness Review

Type 2 diabetes mellitus (T2DM) has traditionally been managed with oral medications. However, in the last few years, subcutaneous glucagon-like peptide-1 (GLP-1) receptor agonists have risen to fame. These agents serve as a reliable addition to current monotherapy. GLP-1 receptor agonists offer a significant reduction in hemoglobin AlC (HbAlc), fasting plasma glucose, and have the added benefit of weight loss. They work primarily by enhancing glucose-dependent insulin secretion while inhibiting glucagon secretion. The available GLP-1 agonists are Byetta® (exenatide), Victoza® (liraglutide), and Bydureon™ (exenatide extended-release). Studies suggest that they are similar in safety and efficacy, with the longer acting GLP-1 …


Sildenafil As An Appropriate Monotherapy Option In The Treatment Of Pulmonary Arterial Hypertension (Pah), Kaitlin Horton, Kent Wilin, Sarah Ginty, Lara Long, David Bright Oct 2019

Sildenafil As An Appropriate Monotherapy Option In The Treatment Of Pulmonary Arterial Hypertension (Pah), Kaitlin Horton, Kent Wilin, Sarah Ginty, Lara Long, David Bright

Pharmacy and Wellness Review

Pulmonary arterial hypertension (PAH) is a debilitating disease characterized by constriction in the diameter of the pulmonary arterial lumen.1,2 This leads to increased pressure and stress on the right ventricle of the heart, which may lead to heart failure and death.2,3 Currently there are only a few treatment options for patients with PAH. Sildenafil, a phosphodiesterase type 5 (PDE-5) inhibitor, can be used to treat PAH. Sildenafil inhibits the degradation of cyclic guanosine monophosphate (cGMP). Increased cGMP concentration results in pulmonary vasculature relaxation. Current clinical trials have indicated that sildenafil can significantly improve many of the symptoms of PAH. The …


Use Of Pharmacogenomics In Mtm Services, Molly Kulp, Halle Orlinski, Zachary R. Jones, Zachary Crawford, David Kisor Oct 2019

Use Of Pharmacogenomics In Mtm Services, Molly Kulp, Halle Orlinski, Zachary R. Jones, Zachary Crawford, David Kisor

Pharmacy and Wellness Review

Incorporation of pharmacogenomic data into Medication Therapy Management (MTM) allows pharmacists to optimize treatment regimens for patients leading to better overall outcomes. Utilizing pharmacogenomics makes it easier for health care professionals to initiate medication regimens with reduced adverse reactions, improves outcomes due to specialized dosing and therapies and allows the treatment process to be as cost-effective as possible for the patient. Pharmacists have an opportunity to educate the rest of the health care team on issues such as: which ethnicities possess higher odds of carrying certain genetic variants, the most common or most relevant medications that can have variable effects …


Overview Of Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis, Christina Spinaris, Sarah Kradel, Tara Tokar, Zachary Crawford, Michael M. Milks Oct 2019

Overview Of Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis, Christina Spinaris, Sarah Kradel, Tara Tokar, Zachary Crawford, Michael M. Milks

Pharmacy and Wellness Review

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immunologic reactions that typically present due to drug hypersensitivity. These reactions present with serious mucocutaneous manifestations that can lead to significant morbidity and mortality. The pathogeneses of SJS and TEN have yet to be clearly elucidated, but three potential immunologic mechanisms have been defined in literature: granulysin, Fas-FasL, and perforin and granzyme B. Medications have been immunologically linked as the primary causative agents of SJS/TEN. Corticosteroids, intravenous immunoglobulin administration (IVIG) and cyclosporine have been employed as treatments; however, none have resulted in consistent positive outcomes. Pharmacists have a significant role in …