U.S. Pharmacist - February 2016

Issue: February 2016 • Archive

In This Edition		Featured Article		Featured CE
• Editor's Notebook • Counseling Pearls • It's the Law • Clinical Corner • TrendWatch • Educational Spotlight • Quick Poll – PPIs and Dementia		Cardiovascular Complications of Ketoacidosis Electrolyte disturbances and catecholamine release can result in acute cardiovascular changes.		Staging and Management of Heart Failure Guideline-directed medication therapy, education, and lifestyle modifications are essential.

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Editor's Notebook

Greasing the Silent Wheel

Blood lipid screening offered by pharmacies can help busy people keep track of their cholesterol levels.

Counseling Pearls

Recommending Aspirin for Primary Prevention of Cardiovascular Disease

Certain patient populations may be candidates for low-dose therapy when the benefits of taking aspirin for cardiovascular protection outweigh the harms. More convincing research on the use of aspirin in primary prevention is necessary.

Medications Associated With Implantable Cardiac Devices

Pharmacists must know how drugs affect the efficacy and safety of these apparatuses. Some medications can interfere with a device's functioning, whereas others can prevent inappropriate shocks.

It's the Law

Pharmacists Prescribing Birth Control

Oregon is the first state to allow pharmacists to prescribe hormonal contraceptives to women.

Clinical Corner

Dual Antiplatelet Therapy Duration in Patients With Drug-Eluting Stents

To prevent progressive atherosclerosis with these stents, current guidelines recommend a course of dual antiplatelet therapy for 12 months. Studies suggest benefits to extending therapy in patients with first-generation stents.

Breaking Down Glioma: A Pharmacist's Overview

Brain tumors are among the most complex and dynamic disease states many pharmacists will encounter. The classification and treatment of gliomas depend largely on individual tumor presentation.

TrendWatch

Response to Cardiac Arrests in Community Settings

Every day in the United States, 1,000 people experience an out-of-hospital cardiac arrest.

Educational Spotlight

Obstructive Sleep Apnea and Its Health-Related Complications

Untreated sleep apnea may be associated with cardiovascular and neurologic comorbidities.

A Therapeutic Review of Chronic Constipation

Diet and lifestyle modifications are the first steps in the primary management of this common condition.

Antipsychotics and Neuroleptic Malignant Syndrome

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

Newswire

Diabetes Drug May Prevent Recurrent Strokes
New Haven, CT—
A study conducted by investigators at Yale School of Medicine suggests that pioglitazone, which is used for type 2 diabetes, may prevent recurrent strokes and heart attacks in patients with insulin resistance but not diabetes. In the international trial, known as IRIS (Insulin Resistance After Stroke), >3,000 nondiabetic subjects who had had an ischemic stroke or transient ischemic attack in the last 6 months were randomized to pioglitazone or placebo for up to 5 years. Stroke or heart attack occurred in 9% of pioglitazone subjects and 11.8% of placebo subjects—a relative decrease of 24%. Results suggest that, for every 1,000 patients who take pioglitazone for up to 5 years, 28 strokes or heart attacks may be prevented.

Blood Test Could Make It Easier to Control TB
Stanford, CA—
A blood test that can accurately diagnose active tuberculosis (TB) could make it simpler and less costly to control the disease. Stanford University School of Medicine researchers have identified a gene-expression signature that can distinguish active TB from latent TB or other diseases in adults and children. Older diagnostic techniques (e.g., skin-prick test, sputum collection) cannot make these distinctions or are less accurate. The new test, which uses an ordinary blood sample, makes it unnecessary to collect sputum and can signal TB infection in patients with HIV; it also distinguishes latent TB or history of TB vaccine. It does not matter which TB strain is involved or if it has evolved resistance to antibiotics.

Adderall Use Increasing in Young Adults
Baltimore, MD—
New research from Johns Hopkins University Bloomberg School of Public Health indicates that although the number of prescriptions for Adderall remains unchanged in young adults, misuse and emergency department visits related to the stimulant have risen dramatically in this population. An analysis of trends from 2006 through 2011 revealed that mainly individuals aged 18 to 25 years are taking Adderall inappropriately without a prescription, primarily get the drug from friends and family, and are lacking a physician recommen-dation. Investigators, noting that stimulants are used especially by college students as a study aid, theorize that many such students believe that the medication improves their ability to study. Adderall can result in serious adverse effects, and there is little information on long-term effects.