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Optimizing Medication Therapy & Improving Outcomes

September 10, 2015

Managing Gestational Diabetes

Clinical pharmacists can play a vital role on a multidisciplinary team and assist with the management of patients with gestational diabetes. In this innovative practice model, implemented in a community health center working toward the designation of a patient-centered medical home, pharmacists collaborate with women’s health providers to educate patients and manage gestational diabetes. Pharmacists have the opportunity to contribute medication expertise in making pharmacotherapeutic decisions. By collaborating with the clinicians providing obstetric care, pharmacists can offer education on lifestyle modifications, self-monitoring of blood glucose, and drug therapy. Read more.

Gender Differences in Pharmacokinetics

In most clinical trials, women are underrepresented, and gender-specific analysis is uncommon. Sex differences in metabolism (phase I and II) are believed to be the major cause of differential pharmacokinetics between men and women. Many CYP450 enzymes (phase I metabolism) show a sex-dependent difference in activity. Most of the phase II enzymes have a higher activity in men than in women. Activities of these enzymes can also change during pregnancy and with the use of oral contraceptives. Sex differences are also found in other pharmacokinetic parameters such as drug absorption, drug distribution, and excretion. Despite these differences between men and women, sex-specific dosing recommendations are absent for most drugs. Therefore, when a woman consistently experiences less therapeutic effect or more adverse effects from a drug, a change in its dosing regimen may be necessary. Read more.

The Management of Primary Dysmenorrhea

Primary dysmenorrhea is the most common menstrual complaint, and it is frequently self-treated by patients of all ages. Teenagers are especially prone to experiencing dysmenorrhea symptoms and selecting OTC therapies without adult supervision. Nonsteroidal anti-inflammatory drugs and combined oral contraceptives represent first-line therapy for dysmenorrhea pain, but several dietary and herbal supplements also show promise. When possible, pharmacists should educate patients regarding proper drug selection and dosing in order to optimize patient outcomes. Read more.

Medication Therapy Management in the News

Growth Hormone Benefit Lasts for Postmenopausal Women With Osteoporosis

In a Swedish study, growth hormone continued to reduce the risk of fractures and helped maintain bone density in postmenopausal women with osteoporosis, even years after it was administered. Read more.

Younger Patients Decline Tamoxifen Because of Fertility Concerns

Fears about loss of fertility often prompt younger breast cancer patients to decline tamoxifen and other endocrine therapies. Read more

CDC Changes Recommendation for Pneumonia Vaccine Interval

The CDC’s Advisory Committee on Immunization Practices recently adjusted the interval between the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine. Read more.

Real-World Data Confirm Safety of Rivaroxaban in AF Patients

Despite concerns about bleeding and stroke, data suggest that those side effects are low in patients with atrial fibrillation (AF) who are treated with rivaroxaban for stroke prevention. Read more.