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Pharmacist's Letter: September 2016; Vol: 32, No. 9

 

Looking for CPE points with readings that are not lengthy but informative? Pharmacist’s letter provides these readings, there are updates on many different topics every month and is recognised by Singapore Pharmacy Council for your online CPE points.

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Pharmacist's Letter: September 2016; Vol: 32, No. 9

Topic of the month: Knowing the risks carried by certain medications and supplements in heart failure patients

Heart failure patients are often on multiple medications for the management their condition. Hence, there bound to be numerous interactions involved when we introduce new medications to them. It is important to know how these interactions occur in order to make clinically sound decisions. Other than medications, even supplements which are commonly known to be “safe” in the public’s eyes can potentially cause undesirable effects in such population. Refer to CHART: Medications and Supplements With Adverse Effects in Heart Failure to get a better understanding on what to avoid in heart failure.

Clinical updates:

1.    Contraception has been an important aspect especially for women in developed countries. However, many might not know the impact on the safety and effectiveness of contraceptives when one has pre-existing chronic medical conditions. It was found that estrogen-containing contraceptives can increase risk of stroke in women having migraine with aura and increase risk of myocardial infarction in smokers compared with healthy women. Select contraceptives with more confidence with CONTINUING EDUCATION: The Art of Selecting & Prescribing Hormonal Contraception

 

2.    Nitrates are given in patients with angina, acute myocardial infarction and heart failure. Selection can be confusing due to a variety of products and formulations available. Daily nitrate free period of 12-14 hours is important to overcome nitrate tolerance. Read up on CHART: Comparison of Nitrates to compare and understand them.

 

Frequently asked questions at the community pharmacy:

  1. Having unexplainable tooth discoloration? Are there whitening solutions available?
    • Some medications, e.g. antibiotics, chlorhexidine-containing products can cause tooth discoloration. They can cause extrinsic or intrinsic discolouration and can be reversible or permanent. Take a closer look at CHART: Drug-Induced Tooth Discoloration to identify possible causes. Whitening methods are available, refer to COMMENTARY: A Look at Tooth Whiteners for more information.

       
  2. Do you know what are the steps for assessing constipation in adults and selecting appropriate constipation medications? Find out more from ALGORITHM: Treatment of Constipation in Adults