Episodes
Friday Feb 26, 2021
Can a Polypill ‘TIP’ the Scale to a One-Size-Fits All Approach?
Friday Feb 26, 2021
Friday Feb 26, 2021
Creating an ideal therapeutic regimen is often like putting a puzzle together, with adherence being a critical piece of that puzzle. Studies, and clinical experience, show that patients are more likely to adhere to once-daily medication administration when compared to regimens that require more frequent dosing. Given that pill burden and medication cost are an increasing problem, would our patients benefit from a simple, low-cost, one-size-fits-all approach to addressing cardiovascular risk?
Guests: Ebony Isis Evans, PharmD, Katy Pincus, PharmD, BCPS, BCACP, and Sara Wettergreen, PharmD, BCACP
Music by Good Talk
Monday Jan 04, 2021
Is it Time to Add Colchicine to the CVD Cocktail?
Monday Jan 04, 2021
Monday Jan 04, 2021
Systemic inflammation appears to be an important contributor to atherosclerotic cardiovascular disease but, to date, no medications have been approved that specifically target systemic inflammation. Could colchicine, an anti-inflammatory drug that has been used for decades, move from “perhaps-do” to a “must-do” standard of care for patients with coronary artery disease (CAD)? Data from two previous trials have demonstrated colchicine’s positive impact on cardiovascular outcomes. The LoDoCo2 study asks us, again, to consider colchicine for patients with CAD.
Guest Authors: Augustus (Rob) Hough, PharmD, BCCP and Taylor Huff, PharmD
Music by Good Talk
Friday Oct 30, 2020
Friday Oct 30, 2020
Health care professionals often don’t think twice about adding a new medication when a patient is not at goal. But we’re reluctant to stop a medication for a chronic condition when the patient appears to be stable and doing well. Polypharmacy in older adults is a significant problem. It’s costly and increases the likelihood of adverse effects. Several observational studies have suggested that lower blood pressure and multiple antihypertensive medications may be harmful in the elderly. Is it possible to discontinue medications without causing serious harm?
Guest Authors: Keturah Weaver Pharm D, BCPS and Daniel Longyhore Pharm D, M.S., BCACP
Music by Good Talk
Friday Aug 28, 2020
Can VOYAGER Put PAD Patients Back on Their Feet?
Friday Aug 28, 2020
Friday Aug 28, 2020
Peripheral artery disease (PAD) impacts 8.5 million Americans age 40 years or older, often leading to acute limb ischemia, amputation, hospitalization, revascularization, major adverse cardiac events (MACE), and death. In addition to being at very high risk of MACE, more than 10% of PAD patients who had revascularization surgery are hospitalized for major adverse limb events, including acute limb ischemia leading to amputation. Could combination therapy, an antithrombotic regimen comprised of a direct oral anticoagulant and an antiplatelet agent, help prevent limb ischemia and cardiovascular (CV) events in these high-risk patients?
Guest Authors: Navya Varshney, PharmD, BCPS and Rachel Lowe, PharmD, BCPS
Music by Good Talk
Friday Aug 14, 2020
Will Bempedoic Acid provide SERENITY for Patients with Statin Intolerance?
Friday Aug 14, 2020
Friday Aug 14, 2020
Current guidelines recommend statins for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) due to their well-established therapeutics benefits. Unfortunately, many patients are unable to tolerate statins due to statin-associated muscle symptoms (SAMS), most commonly manifested as myalgias. Patients who are unable to tolerate a statin can be challenging to treat. Even if the patient is willing to try a lower dose or a different statin, the patient’s low-density lipoprotein cholesterol (LDL-C) may still be above the recommended threshold. This puts patients unable to tolerate statins at increased risk of ASCVD or of a recurrent cardiovascular event. Is bempedoic acid a useful therapeutic option in patients with SAMS?
Guest Authors: Kara Gurries, PharmD, BCACP and Janeen Ibarreta, PharmD
Music by Good Talk
Friday Jul 31, 2020
Friday Jul 31, 2020
Hypertension is poorly managed in the United States with only 25% of patients achieving optimal blood pressure (BP) control (BP less than 130/80 mmHg). To achieve optimal control, patients require close follow-up and BP-lowering medication regimens need to be titrated and periodically adjusted. Community pharmacists are in a unique position to manage patients who have poorly controlled hypertension. However, significant barriers exist to implementing hypertension management services by community pharmacists including a lack of reimbursement. Is chronic care management (CCM) a viable payment model to support these services?
Guest Authors: Kimberly Zitko, PharmD, BCACP, BCGP and Brittany Schmidt, PharmD, BCACP
Music by Good Talk
Friday Jul 17, 2020
Powerful Placebos and Notorious Nocebos: Implications for Ambulatory Care
Friday Jul 17, 2020
Friday Jul 17, 2020
Imagine you have recommended statin therapy to a patient with diabetes. A few weeks later, the patient experiences leg pain and stops it. Was this patient’s leg pain caused by the statin? Or was it a nocebo effect? Muscle symptoms in placebo-controlled trials of statin therapy range from 3-5%, while rates in real-world observational studies are between 15-20%. Ambulatory care pharmacists have an important role in recognizing and managing placebo and nocebo effects. Understanding the placebo effect allows clinicians to harness the power of placebos. Reframing risks during patient education may decrease nocebo effects.
Guest Authors: Sara Wettergreen, PharmD, BCACP and Joseph Nardolillo, PharmD
Music by Good Talk
Monday Jul 06, 2020
An Incli-ng of Benefit? Efficacy and Safety of Inclisiran for Elevated LDL
Monday Jul 06, 2020
Monday Jul 06, 2020
Lipid management continues to be an essential component in the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD). For the past decade, clinical practice guidelines have gone back and forth about optimal treatment goals but guidelines all agree that statins should be used as the preferred initial therapy. However, there is still a lack of clarity about the optimal add-on therapies. The newest LDL-lowering therapy is inclisiran, a small interfering RNA (siRNA) that targets the PCSK9 pathway.
Guest Authors: Joshua O. Holmes, PharmD, MS and Amanda Schartel, PharmD, BCACP
Music by Good Talk
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 Mar 27, 2020
Should Bedtime be Med-Time for Hypertension?
Friday Mar 27, 2020
Friday Mar 27, 2020
Few medications are specifically dosed at night to optimize outcomes. However, antihypertensive medications may soon belong on our patients’ nightstands. It is common practice for patients to take all antihypertensive medications in the morning, but perhaps daytime dosing doesn’t maximize cardiovascular risk reduction? The potential benefits of chronotherapy and its impact on BP and CV outcomes have been investigated since the 1980s. However, current practice guidelines do not explicitly recommend dosing antihypertensive medications at bedtime.
Guest Authors: Vivian Cheng, PharmD, BCPS and Joseph Saseen, PharmD, BCPS, BCACP
Music by Good Talk