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Complex Patient Case 4: Diabetes, CKD, and Psoriasis

Reason for Visit:  Referred by primary care provider to pharmacy services for education and management; diabetes not responding to oral therapy.

Guest Authors: Jillian Cerullo, PharmD and Michelle Gauvin, PharmD, BCACP, BCGP, CDCES

Expert Panelists: Jennifer Trujillo, PharmD, BCPS, CDCES, BC-ADM and Joshua Neumiller, PharmD, CDCES

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Can Losing Weight Using Semaglutide Prevent a Heart Attack, Ack, Ack, Ack, Ack?

Weight extremes, a body-mass index (BMI) either very underweight or obese, are associated with increased all-cause mortality.  Mortality attributable to obesity is caused by many secondary conditions like metabolic disorders and cardiovascular (CV) disease. Enter the glucagon-like peptide-1 (GLP-1) receptor agonists—initially approved in the treatment of type 2 diabetes— which induce significant weight loss regardless of diabetes status.  But can a weight loss drug decrease CV mortality?

Guest Authors:  Gregory Castelli, PharmD, BCPS, BC-ADM, CDCES and Drake Meaney, PharmD, BCPS

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Prescription for Savings: The Clinical and Economic Impact of Pharmacist-Led Hypertension Management in the U.S.

Pharmacists are the most accessible health professionals and can play a vital role in screening and managing hypertension.  But would an expanded scope of practice that enabled pharmacists to prescribe and manage antihypertensive therapies be cost-effective?

Guest Authors: Stefania Cian, PharmD and Candice Garwood, PharmD, FCCP, BCPS, BCACP 

Special Guest: Dave Dixon, PharmD, BCACP, CLS

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Heartburn Headache: Cumulative PPI Use and Dementia Risk

Omeprazole ranks among the top 10 most prescribed medications in the United States, and many patients take proton pump inhibitors (PPIs) for years. Widespread PPI use persists despite data about potential serious adverse effects.  Some worry that PPI use increases the risk of dementia.  Are those worries supported by data?

Guest Authors:  Molly M. Corder, PharmD, BCPS, BCACP and Ryan S. Ades, PharmD, BCPS

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Does Size Matter? The Surprising Impact of Cuff Size on Blood Pressure Readings

Most clinical settings now use oscillometric BP devices to measure patients’ BP, and over half of people with hypertension (HTN) use a home BP monitor.   Can we trust these BP readings if an inappropriate cuff size was used? How will this impact the way we assess BP control?

Guest Authors:  Vincent Lam, PharmD and Kathleen Pincus, PharmD, BCPS, BCACP, CDCES

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Defining the Role of Semaglutide in Obese Patients with Heart Failure with Preserved Ejection Fraction

Over 75% of heart failure with preserved ejection fraction (HFpEF) patients have a comorbid diagnosis of obesity. Obesity is an independent risk factor for the development of HFpEF and contributes to disease progression. Obese patients with HFpEF have greater symptom burden, reduced functional capacity, and impaired quality of life when compared to those without obesity.  We know that patients often struggle to adhere to lifestyle modifications long enough to see meaningful weight loss, but the benefits of GLP-1 agonists for patients with HFpEF who are obese are not yet clear.

Guest Authors: Alicia M. Nordberg-Payne, PharmD; Rebecca Munger, PharmD, BCACP; Jason Zupec, PharmD, BCACP

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Do Statins “REPRIEVE” People Living with HIV from CV Events?

As people living with HIV age, the risk of cardiovascular disease becomes the greatest threat to their health and quality of life. Not only does inflammation from HIV infection contribute to atherosclerotic cardiovascular disease (ASCVD), but dyslipidemia from the antivirals commonly used to treat HIV further enhances that risk. But does statin therapy reduce ASCVD risk in patients living with HIV?  That's the question that the REPRIEVE study attempted to answer.

Guest Authors:  Laura Lerner, PharmD and Joseph Nardolillo, PharmD, BCACP

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Top Ten Things Every Clinician Should Know About the RSV Vaccines

Respiratory syncytial virus (RSV) is a common respiratory virus that typically causes mild cold-like symptoms but can potentially cause severe illness in children and older adults. Every year, thousands of older adults and infants are hospitalized due to RSV, and 10,000 or more die.  In 2023, two vaccines (Abrysvo and Arexvy) and a monoclonal antibody (Beyfortus) became available to help prevent lower respiratory tract disease (LRTD) associated with RSV. 

Complex Patient Case 3: Treatment Resistant Hypertension

Reason for Visit: JT was referred by his PCP to the ambulatory care pharmacist for hypertension management.

Chief complaint: “My medication is making my mouth dry. I want to stop it.”

Guest Authors: Sabrina Silviera, PharmD and Megan Scalia, PharmD, BCACP

Expert Panelists: Eric MacLaughlin, PharmD, BCPS and Joseph Saseen, PharmD, BCPS, BCACP, CLS

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Should We Be Good SPORTs About Supplements for Cholesterol?

Can supplements marketed for cardiovascular health be used in place of statin therapy? Health professionals have long been wary of nutraceuticals and dietary supplements due to the lack of safety and efficacy regulations. The SPORT trial attempts to provide robust data, to practitioners and patients, on how common supplements perform compared to statin therapy. 

Guest Authors: Kaitlyn Phillips, PharmD, Lindsey Pitt, PharmD, and Anna Love, PharmD, BCACP

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