Optimizing Medication Therapy & Improving Outcomes

March 30, 2017

Urate-Lowering Therapy for the Prevention and Treatment of Gout Flare

Gout is one of the most common rheumatologic arthritic diseases in the United States. Preventing future gout attacks requires lowering serum urate levels to promote dissolution of urate crystals, which is accomplished by reducing the production of serum uric acid or promoting its excretion. Xanthene oxidase inhibitors (XOIs), including allopurinol and febuxostat, are first-line agents for the prevention of acute attacks. Probenecid, a uricosuric agent, is an appropriate adjunctive therapy or second-line agent when XOIs are contraindicated or poorly tolerated. Recently, several third-line agents (e.g., pegloticase, lesinurad) have become available for the treatment of refractory gout. Read more.

Acute Pain Management in Patients With Opioid Tolerance

Prescription opioid use has significantly increased globally in the past two decades and has led to an increased number of patients who have become tolerant to opioids. Analgesia in this patient population poses a challenge, and there is a risk of undertreatment. In addition to providing effective analgesia, it is important to prevent withdrawal symptoms and address any related psychosocial issues. Therefore, a multidisciplinary and multimodal approach in pain management is necessary to provide effective analgesia in this patient population. Read more.

Treatment Options in Managing Acute Perioperative Pain

Perioperative pain management is an area of focus among surgeons and anesthesiologists for the surgical patient; however, if the interventions and drugs employed do not adequately treat the underlying pain, the pain could develop into a chronic problem or worsen patient outcomes. The pharmacist can play a valuable role in the pharmacological understanding of the different medications used in the perioperative clinical setting. Various techniques are used in the management of perioperative pain, including neuraxial opioid analgesia, patient-controlled analgesia with systemic opioids, peripheral regional analgesia, and multimodal agents. Pharmacists’ knowledge of pain and appropriate strategies in the treatment of acute perioperative pain can be beneficial to their patients’ well-being. Read more.

Medication Therapy Management in the News

Two Antibiotics Are Better Than One for Deadly Infection

Combining ceftazidime with avibactam plus aztreonam appears to be a significant step toward defeating infections such as carbapenem-resistant enterobacteriaceae. Read more.

Undertreatment Based on Guidelines Decreased COPD Exacerbations

Failing to follow international guidelines on treatment of chronic obstructive pulmonary disease wasn’t always bad medicine, a new study reveals. Read more

Biosimilar of Crohn’s, UC Biologic Therapy Found to Be Safe, Effective

A recent analysis offers evidence that a new and lower cost biosimilar for infliximab—called CT-P13 (Remsima/Inflectra)—has excellent clinical efficacy and safety. Read more.

Blood Levels of Antidepressant, Antianxiety Drugs Linked to Hip Fractures

Older patients who had broken a hip were found to have used antidepressant and antianxiety medications more frequently than the general older population. Read more.