Pharmacist’s Letter: March 2017; Vol: 33, No. 3

Hello! Look nowhere for CPE points! Pharmacist’s letter readings are informative and yet not too lengthy. There are updates on various topics every month and these readings are recognized by the Singapore Pharmacy Council for online CPE points.

Let this be your monthly update of pharmacy knowledge and discover that this process can be enjoyable with materials done up by pharmacists in a highly simplified, structured and concise manner!

Topic of the month: Changes in preferred drug regimens for H. pylori                                                                                              

As clarithromycin resistance exceeds 15% in many parts of North America, there has been a shift from the traditional triple therapy to concomitant quadruple therapy consisting of amoxicillin, metronidazole, clarithromycin and a proton pump inhibitor (PPI) to improve the rates of eradication. Longer duration of treatment (i.e. 14 days) is also recommended over the usual 7 to 10 days. In Singapore, the resistance rate for clarithromycin is also on the rise rendering the traditional triple therapy less effective for some patients. Check out the CHART: H. pylori - From Diagnosis to Eradication to learn more about the latest guidelines.   

Clinical updates:

1. Which corticosteroid to recommend for asthma exacerbations?
   
   ew evidence seems to suggest that single dose of dexamethasone might work as well as 5 days of prednisolone for mild to moderate asthma exacerbations. However, the optimal dose and duration has not been well established. Hence, do continue to recommend the use of prednisolone and empower patients to utilize their short acting bronchodilator appropriately for acute symptoms relief. Have a look at the PL article to better understand how pharmacists can help improve asthma care.
   
    
2. What is the role of low-density lipoprotein (LDL) testing for patients on statins?
   
   The 2013 American College of Cardiology (ACC) lipid guidelines recommend using target dose of statins to reduce cardiovascular risks instead of a specific LDL goal. However, LDL monitoring can still be recommended 4 to 12 weeks after initiation and annually to assess adherence and response to the therapy. Listen to the PL voices and see the CHART: Lipid treatment FAQs to learn more about cholesterol management tips.

Frequently asked questions at the community pharmacy:

1. What is the passport to staying healthy during international travel?
   
   With international travel becoming increasingly common, more and more travelers will drop by the pharmacy with questions regarding travel health. Familiarize yourself with the CDC website and check out the online CEs on immunization and travel medicine to better answer questions pertaining to travel related illnesses, prophylactic medications and vaccinations.
   
    
2. Should I routinely clean my ear?
   
   Earwax also known as cerumen is a naturally occurring substance that cleans, lubricates, and protects the ear canal. In most cases, earwax does not need to be removed unless there are symptoms of impaction such as itching, pain, hearing loss, and tinnitus. Among the various methods of earwax removal, which is better? Refer to the CHART - Earwax Removal Methods to find out more.