Pharmacist Letter: Aug 2016; Vol: 32, No. 8

Having too many things to read but too little time? Looking for a resource that gives timely updates on important topics relevant to pharmacists and pharmacy practice minus the wordiness? Then look no further!

Pharmacist’s Letter is created by pharmacists for pharmacists. Unlike other medical resources out there, Pharmacist’s Letter focuses on drug therapy on every certain topic. It distils all the relevant information and focuses on what is important for a practicing pharmacist to know. Adding Pharmacist’s Letter as part of your routine source of drug knowledge will arm you and get you ready for patient care rounds, patient questions, and topic presentations.

What’s New on Pharmacist Letter: Aug 2016; Vol: 32, No. 8

Topic of the month: Cardiovascular impact when choosing DM medications

We're used to suggesting diabetes meds based on their A1C lowering, side effects, cost, etc. But now CV impact will also be important.

When initiating therapy for DM, there are plenty of anti-diabetic medications to choose from, however, besides metformin, no other anti-diabetic meds have proven beneficial in terms of lowering cardiovascular risk. In fact, use of some anti-diabetics (e.g. rosiglitazone, tolbutamide) has been linked to worse cardiovascular outcomes. The EMPA-REG trial was a trial showing reduced overall cardiovascular death rates, overall death rates, and hospitalizations due to heart failure with empagliflozin. Listen to the latest PL VOICES - Clinical Recommendations to get updated in DM therapy.

Clinical updates:

1. Pregabalin’s human fetal risk is largely unknown. But in pregnant animals given many times the human pregabalin dose on a mg/kg basis, fetal toxicities were observed and they include skeletal malformations, growth retardation, nervous and reproductive system functional impairment, and organ malformations. A new report links first trimester use with a slightly higher risk of major birth defects such as nervous system or skeletal problems. Find out more about safety of pregabalin in pregnancy and its alternatives in this PL update.

2. There is an on-going debate over whether SGLT2 inhibitors (Jardiance etc.) harm or help the kidneys in type 2 diabetes patients. New warnings suggest that canagliflozin (Invokana etc.) or dapagliflozin (Farxiga, etc.) can cause acute kidney INJURY. But other recent evidence suggests the SGLT2 inhibitors, or "flozins," may be PROTECTIVE.  So what is the conclusion? Listen to the experts discuss on the Renal Effects of Diabetes Medications.

Frequently asked questions at the community pharmacy:

1. Does Alka Seltzer (Effervescent Aspirin + Antacid) help with GERD?
   
    The U.S. Food and Drug Administration (FDA) is warning consumers about the risk of serious bleeding when using nonprescription, also known as over-the-counter or OTC, aspirin-containing antacid products to treat heartburn, sour stomach, acid indigestion, or upset stomach. Read more in this PL update on OTC management of GERD.
   
    
2. Do you know the difference between the types of alcohol (e.g. ethyl alcohol, isopropyl alcohol, etc.) and their uses?
   
   Find out more in this PL Update