Optimizing Medication Therapy & Improving Outcomes

January 30, 2017

An Overview of the Management of Concussion

Each year, 1.7 million people in the United States sustain a traumatic brain injury (TBI), which is twice as likely in men compared with women. TBI is an injury to the head that results in a disruption of normal functioning of the brain. The terms concussion, the most common form of TBI, and mild TBI are often used interchangeably. A concussion results most often from a blow or jolt to the head that causes the brain to collide with the skull. The signs and symptoms of a concussion may be physical, cognitive, emotional, or relating to sleep. Both pharmacologic approaches (medication management for cognitive, emotional, and neurologic symptoms) and nonpharmacologic approaches (cognitive and physical rest) are essential for treatment. Read more.

Eslicarbazepine and Other Treatment Advances for Focal Seizures

Epilepsy and the corresponding seizure disorders, such as focal (partial-onset) seizures, provide challenges for both patients and healthcare providers. Although many current treatment options show benefit in some patients, other patients have seizures that fail to respond to medications. Traditional medications, such as phenytoin, carbamazepine, and oxcarbazepine, are known for drug-drug interactions and intolerable adverse effects. Research has resulted in treatment advances for focal seizures. One new medication, eslicarbazepine, has been proven safe and effective for the treatment of focal seizure disorder. With convenient dosing and improved tolerability, eslicarbazepine and other new agents are considered suitable alternatives to traditional antiepileptics in selected patients. Read more.

Nonbenzodiazepine Receptor Agonists for the Management of Insomnia

Insomnia is a disorder due to inadequate sleep quantity and/or quality caused by impaired sleep initiation, maintenance, or duration. Understanding potential nonpharmacologic and pharmacotherapeutic treatment options for insomnia is a vitally important role for pharmacists. Many practitioners and patients are avoiding benzodiazepine receptor agonists (BZDRAs) due to their significant adverse-effect profiles, so pharmacists should understand the appropriate utility of the five FDA-approved non-BZDRA options. Diphenhydramine and doxylamine are generally not recommended due to efficacy and safety concerns, while doxepin, ramelteon, and suvorexant all appear to be efficacious options in the management of insomnia. Read more.

Medication Therapy Management in the News

Hearing Loss Associated With Longer Term OTC Painkiller Use

Longer duration of ibuprofen or acetaminophen use is associated with higher risk of hearing loss, according to new research using data from the Nurses’ Health Study. Read more.

Higher COPD Rates in Nonsmoking Women, Especially African-Americans

A new report points out that 7% of never-smoking older African-American women and 5.2% of white older women have a COPD diagnosis, compared to 2.9% of never-smoking older white men. Read more

PPIs Can Decrease Chemotherapy Effectiveness in Some Patients

A report in JAMA Oncology notes that the common medications can decrease effects of capecitabine, a type of chemotherapy usually prescribed to gastric cancer patients. Read more.

More Antidepressant Side Effects in Panic Disorder Patients

University of Illinois at Chicago–led researchers found that patients with depression and panic disorder were more likely than those with only depression to self-report various side effects. Read more.