Episodes
Friday Feb 03, 2023
Friday Feb 03, 2023
Hyperkalemia is a common electrolyte disorder in patients with CKD that can be exacerbated by renin-angiotensin-aldosterone system (RAAS) inhibitors. While hyperkalemia poses potential risks to patients with CKD, the potentially negative impact of discontinuing RAAS inhibitor therapy on long-term renal and cardiovascular outcomes in CKD patients is unclear.
Guest Author: Michelle A. Fravel, PharmD, BCPS
Music by Good Talk
Friday Sep 16, 2022
Friday Sep 16, 2022
Unsurprisingly, medication burden increases as we age. At each clinic visit, we consider starting new medications, but it’s still relatively uncommon to critically evaluate medications that could be deprescribed. How can we change the culture to embrace deprescribing as an integral part of patient care? The OPTIMIZE study was a provider- and patient-level educational intervention that attempted to increase deprescribing.
Guest Authors: Kashelle Lockman, PharmD, MA and Sarah Greiner, PharmD
Music by Good Talk
Friday Aug 05, 2022
Managing Pain in Patients with High Blood Pressure: Is There No Safe PATH?
Friday Aug 05, 2022
Friday Aug 05, 2022
Pain and hypertension are two of the most prevalent conditions worldwide. Acetaminophen is often considered the “go-to” and the “safe” over-the-counter analgesic for patients with hypertension because it is not commonly believed to increase blood pressure or cardiovascular events. But is that assumption grounded in evidence?
Guest Authors: Lizzie Baumeister, PharmD and Austin Morgan, PharmD, BCACP, CDCES
Music by Good Talk
Friday Apr 08, 2022
On the Look Out for Prescribing Cascades
Friday Apr 08, 2022
Friday Apr 08, 2022
Is my patient’s forgetfulness due to dementia or diphenhydramine? In older adults, adverse drug events (ADEs) can often be misinterpreted and lead to the initiation of new medications, which carry their own risks of ADEs … that can be misinterpreted as a new problem … leading to even more medications being prescribed. In this episode, our guests critically examine a study that identified a new prescribing cascade: gabapentinoid -> diuretics.
Guest Authors: Veronica Arceri, PharmD and Mallory Telese, BA, PharmD, BCACP
Music by Good Talk
Friday Apr 02, 2021
FAST Take: Update on Febuxostat Cardiovascular Safety
Friday Apr 02, 2021
Friday Apr 02, 2021
We know gout is among the many comorbidities that increase the risk of cardiovascular disease (CVD). In 2018, the cardiovascular safety of febuxostat and allopurinol in patients with gout and cardiovascular morbidities (CARES) trial concluded that febuxostat was non-inferior to allopurinol. BUT, two of the secondary endpoints were very concerning. Febuxostat was inferior to allopurinol in terms of cardiovascular death and all-cause mortality. Many clinicians were left wondering whether febuxostat was cardiotoxic …. or conversely, perhaps allopurinol was cardioprotective. Will another cardiovascular outcome trial provide greater clarity to guide clinical practice?
Guest Authors: Sophia Dietrich, PharmD and Michael W. Nagy, PharmD, BCACP
Guest Panelist: Dawn Fuke, PharmD, BCPS
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
Friday May 22, 2020
Friday May 22, 2020
Many studies have linked proton pump inhibitor (PPI) use to several adverse effects including Clostridium difficile-associated diarrhea, community-acquired pneumonia, bone fractures, and nutritional deficiencies. Other reports have linked PPI use with chronic kidney disease, cognitive decline, myocardial infarction (MI), stroke, and even death. Many patients take PPIs chronically and may be concerned about the risk of these side effects. This poses a challenge for healthcare providers as safety data has been primarily based on retrospective and observational studies. A recently pre-planned analysis using data from the prospective COMPASS study sheds some reassuring light.
Guest Authors: Hindu Rao, PharmD and Jelena Lewis, PharmD, BCACP, APh
Music by Good Talk
Friday Jan 18, 2019
Fall Risk and Benzos – Is Trazodone Really the Knight in Shining Armor?
Friday Jan 18, 2019
Friday Jan 18, 2019
Older adults are often tormented by insomnia, pain, and other comorbidities that impact their quality of life. Medication therapy is often sought to treat and manage these diseases, but healthcare providers often overlook the risks of prescribing medications to patients who are older, frail, and at high risk for falls. Trazodone is increasingly prescribed for insomnia instead of benzodiazepines presumably because it is considered to be safer and it does not appear on either the Beers or STOP/START lists. But is trazodone really safer for patients than benzodiazepines?
Guest Authors: Anthony M. Todd, PharmD and Nicole A Slater, PharmD, BCACP
Music by Good Talk