Optimizing Medication Therapy & Improving Outcomes

November 30, 2015

QTc Prolongation With Antidepressants and Antipsychotics

QT prolongation is a rare adverse event associated with many drugs, including antipsychotics and antidepressants. The majority of cases have occurred in patients taking an offending agent with multiple identifiable risk factors for corrected QT (QTc) prolongation. Typical antipsychotics have been implicated in many cases of torsades de pointes and QTc prolongation. Most atypical antipsychotics are considered to have a better cardiac profile. Tricyclic and tetracyclic antidepressants and selective serotonin reuptake inhibitors have also been linked to QTc prolongation. Serotonin norepinephrine reuptake inhibitors have a better adverse-event profile. Clinicians should strive to use antipsychotics or antidepressants with a lower risk of QTc prolongation in patients with multiple risk factors for this adverse event. Read more.

Coexistent Mental Health Disorders in Diabetic Patients

Depression, anxiety, and schizophrenia are some of the mental health comorbidities seen in the diabetic population. Managing diabetes in the context of these mental health disorders can be extremely challenging. Proper control of diabetes requires active patient participation and is dependent upon compliance with lifestyle modifications, self-monitoring, and prescribed medications. Poorly controlled mental health disorders may likely affect patients’ ability to self-manage diabetes. Identifying and treating mental health disorders is an essential component of diabetes management that can be accomplished in an integrated manner by multidisciplinary team members. Pharmacists working with this patient population can provide a number of services—such as individual assessment, collaborative goal setting, skill building, ongoing monitoring, and medication management—to improve patient outcomes. Read more.

Treatment of Alcohol Withdrawal Syndrome

Alcohol withdrawal syndrome (AWS) can occur when an individual stops or even significantly reduces alcoholic consumption after a prolonged period of use. Mild symptoms can occur within hours after the last drink and, if left untreated, may progress to more severe, life-threatening symptoms. Depending upon the severity of withdrawal symptoms, patients may be treated in the inpatient or outpatient setting. Pharmacotherapy is often necessary for treating patients with AWS to manage the symptoms of withdrawal, prevent the progression to serious complications, and bridge these patients to treatment for maintaining long-term recovery. Although a variety of drugs have some utility in treating this disorder, the benzodiazepines remain the agents of choice. Read more.

Medication Therapy Management in the News

Cardiovascular Events Not Increased for Healthy Testosterone Users

Supplemental testosterone does not increase their risk of experiencing a heart attack or stroke for generally healthy men who used therapy to normalize testosterone levels, according to a new study. Read more.

No Improved Outcomes for Black Asthma Patients on Long-Acting Beta Agonists

Which is more effective in improving time to an asthma exacerbation for black adults using an inhaled corticosteroid: a long-acting beta-agonist or the anticholinergic tiotropium? It doesn’t appear to make a difference, according to a study published recently in the Journal of the American Medical Association. Read more

No Sufficient Evidence for Omega-3 Use in Major Depressive Disorder

New research published in the Cochrane Library concludes that there is insufficient evidence for taking an omega-3 fatty acid supplement in treating this mental health disorder. Read more.

Legitimate Opioid Use Prior to High School Graduation Increases Abuse Risk

Having a prescription for opioids prior to 12th grade is independently associated with future opioid misuse, even among teenage patients with little drug experience, according to a new study.  Read more.