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Issue:  March 2016 •  Archive  •  Subscribe •  Unsubscribe
In This Edition Featured Article Featured CE
•  Editor's Notebook
•  Counseling Pearls
•  Senior Care
•  Clinical Corner
•  Consult Your Pharmacist
•  Educational Spotlight
•  Quick Poll
     – Opioids
  Photo NSAIDs: Balancing the Risks and Benefits
The FDA has strengthened the warnings regarding cardiovascular risk with NSAID use.
  Photo Managing Chronic Pain Syndromes
Diabetic peripheral neuropathy, HIV/AIDs neuropathy, and postherpetic neuralgia adversely affect a patient's quality of life.
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Editor's Notebook
The Many Faces of Pain

However a particular culture drives a patient's pain reaction, healthcare providers—including pharmacists—would be wise to consider these behavior patterns.
Counseling Pearls
Photo National Pain Strategy: Implications for Pharmacy Practice

This comprehensive population health-level plan addresses the issue of inadequate pain management in the United States, as well as the national opioid-abuse epidemic. It focuses on six areas: population research, prevention and care, disparities, service delivery and reimbursement, professional education and training, and public awareness and communication.
Photo Treatment of Fibromyalgia Pain

Widespread musculoskeletal pain characterized 
by both somatic and psychological symptoms is
difficult to control. Treatment should include both
pharmacologic and nonpharmacologic options. Three
medications (duloxetine, milnacipran, pregabalin) are
FDA-approved for fibromyalgia, with selection based
on the patient's overall characteristics.
 
Senior Care
Central Post-Stroke Pain Syndrome

Pain is one of the most common, troublesome, and underappreciated consequences of stroke; it is also difficult to manage, particularly in the elderly.
 
Clinical Corner
Photo Pharmacist Involvement in Hospice and Palliative Care

Hospice and palliative-care practice requires health professionals who not only seek to provide care to patients with end-of-life challenges, but also are able to deliver such care with the proper degree of empathy. It is anticipated that increasingly more people will seek these services for themselves or a family member.
Photo Chronic Post-ICU Pain and Post–Intensive Care Syndrome

Post–intensive care syndrome (PICS) is a myriad of chronically debilitating symptoms, often including chronic pain, associated with prolonged ICU care. Increasing emphasis on long-term outcomes of ICU survivors makes prevention of chronic pain and PICS a priority for multidisciplinary ICU teams.
 
Consult Your Pharmacist
Diabetic Peripheral Neuropathy: How Can We Help Our Patients?

To prevent this common long-term complication of diabetes, it is important for pharmacists to provide education on appropriate foot care as well as the importance of regular foot examinations.
 
Educational Spotlight
Staging and Management of Heart Failure

Guideline-directed medication therapy, education, and lifestyle modifications are essential.
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.
 
Newswire
Black Box Added to Immediate-Release Opioids
Silver Spring, MD—
The FDA has announced required classwide safety labeling changes for immediate-release (IR) opioid pain medications, including oxycodone, hydrocodone, and morphine. These updates include a new boxed warning about the serious risks of misuse, abuse, addiction, overdose, and death. There is also a precaution that chronic maternal use of opioids during pregnancy can result in neonatal opioid withdrawal syndrome (NOWS), which may be life-threatening. Because of these risks, IR opioids should only be reserved for severe pain that is not adequately treated by other options. These latest actions are part of the FDA's overall effort to help inform prescribers about the importance of balancing the serious risks of opioids with their role in managing pain.
SSRIs Do Not Increase Risk of Cardiovascular Outcomes
Nottingham, UK
According to a new study from the University of Nottingham, selective serotonin reuptake inhibitors (SSRIs) are
not associated with an increased risk of cardiovascular conditions. The researchers examined associations between different antidepressants and
the rates of three cardiovascular outcomes (myocardial infarction, arrhythmia, and stroke or transient ischemic attack) in people with depression. Medical records of 238,963 patients aged 20-64 years with a diagnosis of depression made between 2000 and 2011 were analyzed using the UK QResearch primary care database. The study found no evidence that SSRIs were associated with an increased risk of cardiovascular outcomes, and, in fact, found some indication of a reduced risk of myocardial infarction, particularly
with fluoxetine.
Caffeine Consumption Linked to Miscarriage
Bethesda, MD—
Research conducted by the National Institutes of Health (NIH) and Ohio State University suggests that couples who consume more than two caffeinated beverages daily in the weeks leading up to conception may have an increased risk of miscarriage. The study found that women who drank more than two daily caffeinated beverages during the first 7 weeks of pregnancy saw an increased miscarriage risk. The findings also indicate that the male partner matters too, as male preconception consumption of caffeinated beverages was just as strongly associated with pregnancy loss as females. Previous studies have drawn similar links, but researchers had not been able to single out caffeine as a contributing factor.
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