iForumRx.org

FOMO — Keeping Up With the Primary Literature

This episode is a collaboration between the ACCP Ambulatory Care Practice and Research Network (PRN) ... and iForumRx.org.

Do you experience FOMO (aka fear of missing out) when it comes to the primary literature?  How can you keep on top of the never-ending stream of new evidence that's published (and presented) every day!  Of course, iForumRx is one way to keep abreast of the latest evidence ... but there are lots of great tools out there!  Our guests share with us their favorite tools for keeping up.

Guests:  Greg Castelli, PharmD, BCPS and Kate Cozart, PharmD, BCACP, BCPS, BCGP

Produced by Jonathan Hughes, PharmD, BCPS, BCACP and Anna Love, PharmD, BCACP

Music by lemonmusicstudio from Pixabay

Could a DOAC Replace Warfarin to Treat the Thrombotic Antiphospholipid Syndrome?

The thrombotic antiphospholipid syndrome (TAPS) is associated with atypical thromboembolic events and/or recurrent pregnancy loss. Patients with TAPS are at very high risk of recurrent thrombotic events and require indefinite therapy.  Warfarin therapy is very challenging to manage in this patient population and requires frequent monitoring.  Thus a direct oral anticoagulant would be a welcomed alternative to warfarin by many patients with TAPS.  But are they effective?

Guest Authors: Leslie Walters, PharmD, BCACP  and Jennifer Carie, PharmD, BCACP, BC-ADM

Music by Good Talk

The Top Ten Things Every Clinician Should Know About Sacubitril/Valsartan

Sacubitril/valsartan is considered part of the backbone of guideline-recommended therapies for the management of patients with heart failure. In 2021, sacubitril/valsartan became the preferred treatment over an ACEi or ARB in patients with heart failure with reduced ejection fraction (HFrEF) because it reduces the risk of cardiovascular death and hospitalization for heart failure in nearly all adult patients with chronic heart failure. All clinicians should be familiar with the indications, dosing, safety, and monitoring of sacubitril/valsartan.  Affordability, access, and inappropriate dose titration remain major barriers to achieving optimal outcomes.

Guest Authors:  Jessica Wooster, PharmD, BCACP and Elizabeth Yett, PharmD, BCACP

Special Guest:  Dustin (DJ) Clark, PharmD, BCACP

Music by: Good Talk

Don’t Miss a Beat: The Importance of Influenza Vaccination in Patients with Coronary Disease

Unfortunately, many patients with CAD do not receive the influenza vaccine every year.  And many patients being discharged from hospital after an acute coronary event don't receive it either. The IAMI (Influenza Vaccination After Myocardial Infarction) study was the first, large, randomized, double-blind, placebo-controlled, multi-center trial to investigate whether influenza vaccination could reduce the rate of cardiovascular events in high-risk adults with CAD.

Guest Authors:  Noelle Cordova, PharmD and Laura McAuliffe, PharmD, BCACP, CDCES

Music by Good Talk

Why is Thor’s Hammer, Molnupiravir, Considered a 4th Line Option for COVID-19?

Two novel oral antiviral agents were granted emergency use authorization (EUA) by the U.S. Food and Drug Administration (FDA) for the treatment of mild to moderate COVID-19 in late December 2021. Although it is named after Thor’s hammer, Mjölnir, molnupiravir was given a last place (4^th line) recommendation by the National Institutes of Health (NIH) COVID-19 Treatment Guideline Panel.  What gives?

Guest Authors: Amanda Applegate, PharmD, BCACP and Mary Beth Dameron, PharmD, BCACP

Music by Good Talk

Top Ten Things Every Clinician Should Know about the 2022 Medical Standard of Care for Diabetes

Published in Diabetes Care every January, the Standards of Medical Care in Diabetes by the American Diabetes Association (ADA) provides recommendations for the care of patients with diabetes.  And every year clinicians eagerly read, discuss, and apply them in their practices.  In this episode, we discuss some of the highlights.

Guest Author: Jennifer N. Clements, PharmD, BCPS, BCACP, CDCES, BC-ADM

Special Guest: Joshua Neumiller, PharmD, CDCES

Music by Good Talk

On the Look Out for Prescribing Cascades

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

Thiazides in Chronic Kidney Disease: New Evidence Challenging Old Dogma

Thiazide diuretics have been in clinical use for more than 60 years. Small studies published in the 1950s/60s reported that chlorothiazide had less diuretic and antihypertensive effect in patients with lower glomerular filtration rates which led to the belief that thiazides are ineffective in advanced CKD.  The Chlorthalidone in Chronic Kidney Disease (CLICK) Trial challenges this dogma.

Guest Authors: Michael Ernst, PharmD, BCGP and Michelle A. Fravel, PharmD, BCPS

Music by Good Talk

Sequential Additions or Multicomponent Combination? Should Our Approach to Hypertension Be Re-examined?

Traditionally, hypertension management involves a stepwise approach where agents are titrated and added. Thus, achieving optimal BP control requires close follow-up, time, and resources.  Outside of these logistics, providers are prone to clinical inertia (aka fail to advance therapy when they should) and sometimes “push back” from patients who experience the burdens of treatment and follow-up. Perhaps it’s time to reconsider our approach to managing hypertension.

Guest Authors:  Erin Connolly, PharmD and Laura Varnum, PharmD, BCACP

Music by Good Talk

Extra Protection? Finerenone Use in Patients with Type 2 DM and CKD

Despite prevention efforts, about 1 in 3 patients diagnosed with diabetes have comorbid CKD. Half of these individuals have moderate to severe disease. Unlike patients with type 1 diabetes where it develops after many years after the diagnosis, CKD is commonly present at diagnosis in patients with type 2 diabetes. While many interventions are available to prevent the progression of CKD, more are needed.

 

Guest Authors: Katherine Montag Schafer, PharmD, BCACP, CDCES and Kyle Hunt, MD

Music by Good Talk