iForumRx.org header image 1

Don’t Let Numbers Fool You: Levothyroxine Isn’t a Cure-all

Patients with subclinical hypothyroidism often complain of symptoms commonly seen in patients with overt hypothyroidism: cold insensitivity, dry skin, fatigue, constipation, muscle cramps, poor memory, slowed thinking, and depression. Indeed, up to a quarter of people with normal TSH levels report up to two of these symptoms, pointing to the non-specific nature of these symptoms. How then should a clinician decide which patients might benefit from thyroid replacement therapy?

Guest Authors:  Mallory Kuchis, PharmD and Michael P. Kane, PharmD, BCPS, BCACP

Music by Good Talk

LDL Limbo: How Low is Too Low?

There has been significant debate regarding the safety of achieving very low LDL-C levels, including a potential negative impact on cognitive function. The current ACC/AHA guidelines (circa 2013) suggest decreasing the statin dose in patients with two consecutive LDL-C levels below 40 mg/dL based on expert opinion. The lack of evidence has been a major challenge for clinicians and it is unclear whether medication doses should be reduced in high-risk patients who may benefit from very low LDL-C levels.  A recently published meta-analysis sought to address this clinical dilemma.

Podcast Case: Very Low LDL Case

Guest Authors:  Apryl Anderson, PharmD and Dave Dixon, PharmD, BCPS, BCACP, CLS, CDE

Music by Good Talk


Top Ten Things Every Clinician Should Know About the 2017 Hypertension Guidelines

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

Pulling Ahead After a SPRINT – Evidence for Lower Blood Pressure Goals

The debate over the intensity of blood pressure (BP) lowering for patients with hypertension has been going on for decades.  Additional fuel to the fire was recently added with the early halt and publication of the Systolic Blood Pressure Intervention Trial (SPRINT).  So “how low should you go” for patients with high BP? Do lower BP goals reduce CV outcomes and death, particularly in patients at high risk?  Do they cause greater adverse effects? Or perhaps even worsen CV outcomes? These questions were examined in SPRINT.

Podbean App

Play this podcast on Podbean App