U.S. Pharmacist - December 2015

Issue: December 2015 • Archive

In This Edition		Featured Article		Featured CE
• Editor's Notebook • Counseling Pearls • It's the Law • Clinical Corner • TrendWatch • Educational Spotlight • Quick Poll – Pharmacist Prescribing		Gastroesophageal Reflux Disease Management in Pediatric Patients It is important to distinguish simple reflux from reflux disease in order to avoid unnecessary diagnostics and therapies.		A Therapeutic Review of Chronic Constipation Diet and lifestyle modifications are the first steps in the primary management of this common condition.

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Editor's Notebook

Gut Feeling About Probiotics

These microorganisms hold particular promise for treating GI diseases, but more research is needed.

Counseling Pearls

Utility of Probiotics in Gastrointestinal Disease

Use of these products may yield improvements in clinical outcomes for a variety of GI disorders. Patients may need help in understanding the key differences between the many available OTC formulations.

The Pharmacologic Management of Motion Sickness

Several effective prescription and OTC treatments are available for this ailment. Still, pharmacists must consider individual patient characteristics before recommending a product.

It's the Law

DEA Form 106 and Loss of Controlled Substances

A pharmacy must report a theft or significant loss of controlled substances to the DEA within one business day.

Clinical Corner

Drug-Induced Bleeding

In many cases, medication is not easily recognized as the cause of a patient’s blood loss. By minimizing the risk of such bleeding in patients, pharmacists can help reduce long-term adverse effects.

Overuse of Proton Pump Inhibitors in the Hospitalized Patient

Stress ulcer prophylaxis, especially with PPIs, has been a key component in managing critically ill patients. However, PPI overutilization has led to higher hospital-related costs and more adverse effects.

TrendWatch

Effects and Prevalence of Viral Gastroenteritis

Most people recover from the highly contagious disorder without complications.

Educational Spotlight

Antipsychotics and Neuroleptic Malignant Syndrome

Treatment involves the discontinuation of the offending agent and supportive therapy.

Regulatory and Safety Issues in Compounding

Recently enacted/proposed rules aim to prevent events such as the 2012 distribution of contaminated injectables by a compounding pharmacy.

Therapeutic Management of Infertility: A Pharmacist’s Perspective

Various treatment options are available to improve the chances of conceiving.

Newswire

Many U.S. Hospitals Do Not Mandate Flu Shots for Staff
Ann Arbor, MI—
Despite national recommendations that healthcare workers receive the flu vaccine to prevent them from passing the virus to their patients, >50% of hospitals do not require it. University of Michigan and Veterans Affairs (VA) Ann Arbor Healthcare System researchers surveyed infection preventionists at 386 hospitals regarding their hospital’s flu-vaccination policies and found that vaccination of providers was required in only 43% of hospitals. In some hospitals, union or staff opposition prevented adoption of a vaccination requirement; administrators’ lack of willingness was another factor. In 22% of non-VA hospitals, providers were strongly encouraged to get flu shots, and in >50% of VA hospitals, vaccination could not be mandated since they were part of a federal system.

Asthma and Chronic Migraine Linked in Some People
Cincinnati, OH—
People with asthma may be more than twice as likely to develop chronic migraines (≥15/month) as those without asthma, according to a University of Cincinnati study of about 4,500 subjects. At baseline, subjects had <15 migraines per month (episodic or occasional migraines), but 1 year later, >5% of those with asthma were experiencing chronic migraines, versus only 2.5% of those without asthma. Although the study was not designed to prove a cause-and-effect relationship, the link between the conditions was robust. Since both asthma and migraine involve inflammation and activation of smooth muscle, it is possible that asthma-related inflammation may lead to migraine progression.

Breast Cancer Recurrence Not Increased When Taking Antidepressants With Tamoxifen
Oakland, CA—
In a large study, women with breast cancer who received tamoxifen while taking an antidepressant did not have an increased risk of recurrence, countering previous studies suggesting that antidepressants reduce the anticancer drug's effectiveness in lowering the subsequent risk of breast cancer. The study population—almost 17,000 early-stage breast cancer survivors treated with tamoxifen, nearly 50% of whom were prescribed antidepressants—were followed for up to 14 years. The risk of recurrence was similar in patients who took antidepressants and those who did not. No increased risk of recurrence was found in patients taking antidepressants regardless of the type of antidepressant used—including paroxetine, which previously was reported to interfere with tamoxifen.