Episodes
Friday Jun 19, 2020
Will Riva Be Defeated By It’s (Long-Standing) Nemesis, Apixa?
Friday Jun 19, 2020
Friday Jun 19, 2020
Do we finally have enough evidence to establish a preferred direct-acting oral anticoagulant (DOAC) for stroke prevention in patients with atrial fibrillation? The use of DOACs for a-fib has rapidly increased due to their ease of use and favorable safety profile. The AHA/ACC/HRS and CHEST guidelines now recommend DOACs over warfarin for stroke prevention in a-fib, but do not state a preference for one DOAC over another. Factor Xa inhibitors, specifically apixaban and rivaroxaban, are the most commonly prescribed DOACs suggesting they are preferred by clinicians in real-world practice but is one better than the other?
Guest Authors: Amy D. Robertson, PharmD, BCACP and Michelle Balli, PharmD, BCACP
Music by Good Talk
Friday Nov 22, 2019
Friday Nov 22, 2019
Several guidelines now recommend direct oral anticoagulants (DOACs) as the preferred anticoagulants for patients with non-valvular atrial fibrillation (a-fib). However, the landmark clinical trials focused largely on the primary prevention of stroke. Moreover, real-world data using DOACs for secondary prevention is lacking. Many have argued that warfarin might be a better choice in these high-risk patients because it requires routine monitoring and increases the patient’s contact with the healthcare system. Does the choice of anticoagulant make a difference in preventing recurrent stroke?
Guest Authors: Blaire White, PharmD; Amber Cizmic, PharmD, BCACP; and Tish Smith, PharmD, BCACP
Music by Good Talk
Friday Dec 14, 2018
Another Attempt to ARRIVE at an Answer Using Aspirin for Primary Prevention
Friday Dec 14, 2018
Friday Dec 14, 2018
Daily low-dose aspirin has long been considered a “wonder drug” for its cardioprotective effects, particularly in patients with pre-existing cardiovascular and cerebrovascular disease; however, despite decades of research, the use of aspirin to prevent a first event is less certain. In 2014, the Food and Drug Administration (FDA) responded to a citizen petition requesting the labeled indications for low dose aspirin be updated to include primary prevention. The FDA concluded that the evidence “fail[ed] to establish that aspirin reduces the risk of primary myocardial infarction (MI) in patients with a coronary heart disease (CHD) risk of 10% or more for over 10 years.” The Asprin to Reduce Risk of Initial Vascular Events (ARRIVE) study is intended to address this gap in our knowledge.
Guest Authors: Amy St. Amand, PharmD, BCPS and Christine Borowy, PharmD, BCPS
Music by Good Talk
Friday Dec 15, 2017
Friday Dec 15, 2017
We interview Eric MacLaughlin, Joseph Saseen, and Kristin Rieser about the ACC/AHA Guidelines for the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure in Adults released in November 2017. Dr. MacLaughin, a member of the Guideline Writing Committee, gives a insiders view of the guidelines development process and explains the rationale for lower blood pressure goals. Drs. Saseen and Rieser talk about some of the practical considerations that we all must consider as we move forward to making these recommendations a reality.
Guests: Kristin Rieser, Pharm.D., Joseph Saseen, Pharm.D, and Eric MacLaughlin, Pharm.D.
Music by Good Talk
Friday Apr 14, 2017
Peeling Back the Layers on Coated Aspirin
Friday Apr 14, 2017
Friday Apr 14, 2017
More than 15 million Americans have coronary heart disease and most should be taking aspirin daily. Given aspirin’s ubiquity in cardiovascular medicine and patients’ pill boxes, it is shocking that there are still so many unanswered questions about aspirin use. Which dose and dosage forms should be prescribed? How common is aspirin resistance? What is the relationship between platelet inhibition and clinical outcomes?
Guest Author: Daniela Valencia, Pharm.D.
Theme Music by Good Talk
Friday Mar 25, 2016
Crossing the Periprocedural Bridge in Patients with Atrial Fibrillation
Friday Mar 25, 2016
Friday Mar 25, 2016
For over two decades LMWHs have been routinely used to provide therapeutic coverage in patients who must temporarily stop warfarin. Current guidelines suggest using injectable anticoagulants during warfarin interruption (aka bridging) in patients with atrial fibrillation based on patients’ risk of arterial thrombosis. Using the CHADS2 score to assess risk, the guidelines recommend (grade 2C) bridge therapy if the CHADS2 score is 5 or higher and not bridging if the CHADS2 score is 2 or lower. But what about patients with a CHADS2 score of 3 or 4?
Friday Oct 30, 2015
Taking a CHANCE on Clopidogrel Plus Aspirin to Prevent Stroke Recurrence
Friday Oct 30, 2015
Friday Oct 30, 2015
The CHANCE (Clopidogrel in High risk patients with Acute Non-disabling Cerebrovascular Events) trial investigators examine whether patients who have a TIA or mini-stroke should receive aspirin AND clopidogrel to reduce the risk of recurrent stroke.
Friday Sep 18, 2015
Managing Direct Oral Anticoagulants – What’s Our Role?
Friday Sep 18, 2015
Friday Sep 18, 2015
Many clinicians are questioning the role pharmacists play in anticoagulation therapy management as direct oral anticoagulants (DOACs) increasingly replace warfarin for a variety of indications. A recent study examined medication adherence and therapy management practices at Veterans Health Administration (VHA) patient care sites. Although this study does not have all the answers, it does reveal the importance of patient selection and ongoing patient monitoring – potentially key roles for pharmacists.
Friday Jul 24, 2015
Folic Acid: A Simple Answer to a Very Large Problem?
Friday Jul 24, 2015
Friday Jul 24, 2015
Stroke is responsible for 1 in 19 deaths in the United States and is the leading cause of long-term disability. Could something as simple and cheap as folic acid substantially reduce the risk of stroke? The China Stroke Primary Prevention Trial examined this important question.