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Issue:  April 2013 •  Archive  •  Subscribe •  Unsubscribe
In This Edition Featured Article Featured CE
•  Editor's Notebook
•  Counseling Pearls
•  It's the Law
•  Clinical Corner
•  Consult Your Pharmacist
•  Educational Spotlight
•  Quick Poll
  – DXM Restrictions
  Photo New Treatment Modalities for Obesity
The FDA has recently approved two different agents for weight loss in obese patients.
  Photo The TB/HIV Syndemic: Prevention, Detection, and Treatment
The presence of untreated tuberculosis may hasten the course of HIV infection.
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Editor's Notebook
Fraud, Waste, and Abuse

Pharmacists can help relieve the financial burden that health care excesses place on American taxpayers.
Counseling Pearls
Photo Diabetic Foot Infections: An Update on Treatment

This common complication increases the risk of hospitalization, amputation, and death. Therefore, the treatment and prevention of these infections is critically important.
Photo Immunizations in Adults Taking Disease-Modifying Antirheumatic Drugs

Many live vaccines can potentially cause infection in immunosuppressed patients. It is uncertain which drugs have sufficient immunosuppressive effects to reduce vaccine efficacy or increase risks.
It's the Law
Pharmacists and Prescription Drug Schemes

Two recent cases involve pharmacists charged with running illegal prescription drug schemes.
Clinical Corner
Photo Necrotizing Soft-Tissue Infections: "Flesh-Eating Bacteria"

In more than 20% of cases, the etiology of this life-threatening disorder is unknown. Early aggressive treatment is required to reduce complications and improve survival rates.
Photo Antifungal Therapy for Invasive Aspergillosis

This lethal systemic fungal infection usually affects the lung cells of immunocompromised hosts. If untreated, it can spread to other organs, including the heart and brain.
Consult Your Pharmacist
Home Testing for HIV

Some patients may prefer a test that affords anonymity and/or provides fast results.
Educational Spotlight
Postherpetic Neuralgia: Treatment and Prevention Strategies

Neuropathic pain due to shingles can be alleviated with a variety of options, including antidepressants and antiepileptics.
The Role of the Pharmacist in Managing Hyperlipidemia

Pharmacists can help improve patient adherence to lipid-lowering therapies.
Identification, Prevention, and Treatment Recommendations for Concussions

Sports-related head injuries are being increasingly discussed in an attempt to raise awareness of the severity of complications relating to concussions
Side Effects of Migraine-Prevention Drugs Differ
Minneapolis, MN — A recent review concluded that although drugs routinely prescribed to prevent episodic migraines differ little in efficacy, they vary widely in terms of side effects. The studies included in the review involved mainly middle-aged women who had an average of five migraine attacks per month. The study drugs all prevented at least half of migraines in 200 to 400 patients per 1,000 treated and were more effective than placebo. Off-label antidepressants and antiepileptics caused the worst side effects, with the medication usually being discontinued. Off-label angiotensin inhibitors and beta-blockers caused the fewest side effects. Besides the increased occurrence of immediate side effects, antiepileptics also can cause sexual problems with long-term use, a circumstance that would affect adherence.
High Vitamin E Intake Not a Health Concern
Corvallis, OR— A new review has found that there are biological mechanisms for routine elimination of excess vitamin E that render it nearly impossible to take a harmful amount, whether in the diet or through supplementation. According to Maret Traber, PhD, of the Linus Pauling Institute at Oregon State University, it is impossible for toxic levels of vitamin E to accumulate in the liver or other tissues. Two major systems in the liver routinely excrete excessive amounts of vitamin E, and the very high intakes achieved with supplementation merely double tissue levels, which is not harmful. A more important issue, says Traber, is that more than 90% of people in the U.S. have inadequate vitamin E in their diet.
New Compound Blocks Protein That Interferes With Leptin
Galveston, TX — University of Texas researchers have identified a protein (Epac1) that can interfere with the brain’s response to leptin and have created a compound that blocks Epac1’s action. The specially developed compound, tested in laboratory mice, could lead to an antiobesity drug. Mice genetically engineered to be unable to produce Epac1 had better glucose tolerance and lower blood leptin levels, body weights, and body-fat percentages than normal mice. Epac1 is activated by cyclic AMP, a signaling molecule linked to metabolism and leptin production and secretion. The researchers believe that understanding how cyclic AMP acts through Epac1 will generate new pharmaceutical possibilities, including a drug to fight obesity and diabetes.
To subscribe to e-Connect, send your name, address, and email address to us by clicking here. U.S. Pharmacist is a monthly journal dedicated to providing the nation's pharmacists with up-to-date, authoritative, peer-reviewed clinical articles relevant to contemporary pharmacy practice in a variety of settings, including community pharmacy, hospitals, managed care systems, ambulatory care clinics, home care organizations, long-term care facilities, industry and academia. The publication is also useful to pharmacy technicians, students, other health professionals and individuals interested in health management. Pharmacists licensed in the U.S. can earn Continuing Education credits through Postgraduate Healthcare Education, LLC, accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.