Endocrinology, Diabetes, and Metabolism Commons^™

Fda Approves New Inhaled Insulin: Afrezza® (Technosphere® Insulin), Benjamin Finley, Christina Ciccone, Kimberly Loughlin, Michelle Musser

Pharmacy and Wellness Review

Diabetes is an endocrine disease caused by deficiency or malfunction of insulin that results in high blood glucose levels and places patients at higher risk for a number of complications. This chronic disease is difficult to manage and affects millions of people in the United States, costing the health care system billions of dollars a year. Of a variety of antidiabetic agents used to control blood glucose, insulin is perhaps the most effective, but until recently it was only available in injectable form. As of June 27, 2014, a new inhaled insulin called Afrezza® (Technosphere® insulin) was approved by the …

Polycystic Ovarian Syndrome And Hyperinsulinemia: Overview And Treatment, Amanda M. Meyer, Lauren D. Bajbus, Sarah E. Drake, Kristen M. Quertinmont, Ashley Overy, Anne Gentry

Pharmacy and Wellness Review

Polycystic ovary syndrome is a prevalent issue in women's health that is associated with hyperinsulinemia and insulin resistance and can lead to long-term health problems. The most highly recommended treatments are diet and lifestyle changes. If these changes alone are not enough, pharmacologic treatments may be employed which include metformin, spironolactone or thiazolidinediones, although more research is needed to fully realize their role. The role of the pharmacist in this disease state includes counseling patients on healthy lifestyle changes, consulting with the physician about prescribing the best medication for each patient, and monitoring therapy adherence in the patient.

Metformin And Cancer: Pharmacoepidemiology Considerations, Sarah Kradel, Christina Spinaris, Victoria Pennington, Adam Trimble, Lara Long, Natalie Dipietro

Pharmacy and Wellness Review

No abstract provided.

Hormonal Therapy And Preventive Care Of Transgender Patients, Angela Chu, Jana Randolph, Austin Hopkins, Victoria Cho, Sophocles Chrissobolis

Pharmacy and Wellness Review

Transgenderism occurs when an individual's gender identity conflicts with the individual's biological sex. A variety of methods may be used in order to reconcile this disparity in transgender individuals including psychological counseling, cross-sex hormone therapy and sex reassignment surgery. The most important role for pharmacists in the treatment of transgender patients is in dispensing hormonal medications for cross-sex treatment. Hormone therapy may be used to suppress characteristics of the patient's biological sex as well as to induce development of characteristics that correlate with the patient's gender identity. In male-to-female (MtF) transgender patients, the most commonly used medications include agents which …

Prevention And Treatment Of Glucocorticoid-Induced Osteoporosis, Mackenzie Devine, Anh Dao Le, Julie Puvogel, Victoria Cho, Michelle Musser

Pharmacy and Wellness Review

Osteoporosis is a disease state resulting in decreased bone mineral density (BMD) and increased risk of fracture, specifically of the vertebrae, spine and hip. Risk factors and high risk populations for developing osteoporosis include low BMD, long-term glucocorticoid therapy, genetics, diet, postmenopausal women and patients with inflammatory or chronic disease states. A variety of signaling pathways involving hormones, cytokines and other signaling molecules are involved in bone formation and are affected by long-term glucocorticoid therapy, leading to the development of glucocorticoid-induced osteoporosis (GIO).

There are a variety of drugs that work efficaciously to prevent and treat GIO. Alendronate is a …

Testosterone Replacement Therapy In Aging Males, Alexandra Dimit, Joelle Farano, Haley Armstrong, Michelle Musser

Pharmacy and Wellness Review

The U.S. Food and Drug Administration (FDA) cautions health care providers and patients regarding the use of testosterone replacement therapy products for the aging process, including a decrease in muscle strength, muscle mass, and lack of energy or sexual desire, due to an increased risk of heart attacks and strokes. Testosterone replacement therapy products are indicated for genetic defects, chemotherapy damage, or damage to the hypothalamus or pituitary gland, where testosterone is produced. A patient and his team of health care professionals must seriously consider the risks and benefits when using these products for other indications. Use of testosterone replacement …

Potential Use Of Dopamine And Dopamine Agonists As Angiogenesis Inhibitors In The Treatment Of Cancer, Benjamin Finley, Katherine Liu, Daniel Powell, Jamie Kellner, David H. Kinder

Pharmacy and Wellness Review

In recent years, there have been numerous developments in monoclonal antibodies used as anticancer drugs with a focus on reducing the ability of cancers to metastasize and produce new vasculature. These agents are called angiogenesis inhibitors and although these agents have been proven effective in treating certain types of cancers, production and administration of monoclonal antibodies comes at a steep cost with a severe side effect profile. Under normal physiologic conditions, angiogenesis is an important mechanism to create new blood vessels from preexisting vessels, usually occurring in adults. Tumor cells can hijack the angiogenesis pathway to produce new distant tumors …

Dapagliflozin: A Newly Approved Sglt2 Inhibitor For The Treatment Of Type 2 Diabetes Mellitus, Ann Marie Ruhe, Rachel Muhlenkamp, Austin Brown, Emily Blum, Sandra L. Hrometz

Pharmacy and Wellness Review

Type 2 diabetes mellitus (T2DM) is a chronic disease in which a hyperglycemic state is induced by insulin resistance. While there are numerous treatment options available to manage T2DM, many patients require changes in therapy throughout treatment, as well as multiple medications. The sodium/glucose cotransporter 2 (SGLT2) inhibitors, canagliflozin and dapagliflozin, offer a therapeutic alternative in T2DM management through the utilization of a unique mechanism of action to provide intensified glycemic control. This article will evaluate the safety and efficacy of dapagliflozin in the management ofT2DM.

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 …

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 …

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 …

An Update On Gestational Diabetes, Jamie L. Amero, Jennifer L. Bauer, Sarah M. Webb, Ryan A. Fischer, Lindsey A. Hallman, Sandra L. Hrometz

Pharmacy and Wellness Review

Gestational diabetes is a concern for a large number of pregnant women due to the potential for long-term complications for both the mother and the fetus. With the increasing prevalence of obesity and diabetes in the general public, the number of pregnant women with undiagnosed type 2 diabetes mellitus has also increased. In order to adequately educate their patients, it is important for pharmacists to be aware of the general practices of treating gestational diabetes. This review will highlight recent updates to initial screening, the criteria for diagnosing gestational diabetes, and current management strategies.

Use Of Gastric Bypass Surgery For The Treatment Of Type 2 Diabetes Mellitus, Kaitlin A. Sanders, Jenna L. Schaffner, Leslie M. Hart, Whitney N. Detillion, Anne Gentry

Pharmacy and Wellness Review

Over the past decade, the incidence of type 2 diabetes mellitus (T2DM) has increased significantly. Evidence has shown that a clear association exists between obesity and diabetes development. This association has inspired researchers to explore bariatric surgery as an option for diabetes management and possible disease reversal. Improvement of T2DM using Roux-En-Y gastric bypass (RYGB) is thought to result from from a combination of weight loss, decreased caloric intake, hormonal changes and rearrangement of the gastrointestinal anatomy. Positive outcomes resulting from the procedure include decreased mortality rates, normalization of HbA1c levels, decreased dependence on diabetic medications, and increased insulin sensitivity. …

An Update On Exenatide And Liraglutide For Type 2 Diabetes Mellitus, Sarah M. Webb, Lacey A. Shumate, Ashley M. Overy, Ashley E. Lehnert, Monica A. Weisenberger, David R. Bright, Whitney N. Detillion

Pharmacy and Wellness Review

No abstract provided.