Vaccine success holds hope for end to deadly scourge of Ebola

Ebola outbreak was a fear for the whole wide world. The Guinea trial that started last March was done to test VSV-ZEBOV vaccine, also known as ring vaccine. Close to 4000 people who came into contacts with patients with confirmed cases of Ebola were immunized immediately.  A high protection rates were seen in those who were immunized. This vaccine will be tested now in children as young as age 6. What are your thoughts and concerns about this new vaccine?

For more information please see Reuters

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Addressing opioid drug misuse in America

Morbidity and Mortality Weekly Report published a study that links prescription opioid misuse with illicit opioid use, specifically heroin. The study investigated tendencies of heroin users in the US from 2002 to 2013, among all demographics. There was a 90% increase in the rate of people diagnosed with past-year heroin use or dependence; the majority of which were among men, 19-25 years old, people of less than US$ 20000 annual household income, people living in urban areas, and those without health insurance. Moreover, there was a highest (138%) increase in past year heroin users who reported past year use of non-medical opioid pain relievers, followed by reports of cocaine use.  Some of the initiatives taken to minimize opioid misuse problems include the hand-held auto injector for naloxone that was approved by the FDA and the extensive Prescription Drug Abuse Prevention Plan lunched by the White House. In addition, a recommended action against opioid misuse was to provide better access and insurance coverage to evidence-based substance abuse treatments such as buprenorphine or methadone, promoting naloxone use for opioid pain reliever abuse and heroin overdoses. What programs related to opioid misuse are offered through your practice?

For additional information please read THE LANCET

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New safety warnings for two classes of diabetes drugs: What pharmacists should know?

New safety warnings were issued by the FDA for dipeptidyl peptidase–4 (DPP-4) inhibitors, and sodium–glucose linked transporter–2 (SGLT-2) which are two oral agents for blood glucose control in type 2 diabetes. Warning of heart failure risk associated with one of the DPP-4 inhibitors, saxagliptin, were voted to be included on the drug label based on a large study (SAVOR). The study had nearly 16,500 people with type 2 diabetes and risk factors for cardiovascular events; more hospitalization due to heart failure occurred in the saxagliptin group (3.5%) than in the placebo group (2.8%) over 2 years of follow up. However, two other large randomized controlled trials (EXAMINE and TECOS) did not confirm this risk. The safety warning for SGLT-2 inhibitors was published after reports of diabetic ketoacidosis (DKA), a dangerous accumulation of acid in the blood, which required emergency visit or hospitalization in people with type 1 and type 2 diabetes. Yet, the reports did not prove a cause and effect link between the medications and DKA. When dispensing DPP-4 inhibitors and SGLT-2 inhibitors, it is recommended for pharmacists to assess patients’ specific risk factors and weigh them against benefits, providing appropriate patient counseling. How many of your patients are prescribed these two classes of drugs?

For additional information please visit APhA

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Knowledge and Attitudes Regarding Antibiotic Use Among Adult Consumers, Adult Hispanic Consumers, and Health Care Providers

The Center for Disease Control (CDC) analyzed Internet survey data from 2012-2013 about the knowledge and the consequent attitudes towards antibiotics of approximately 15,000 health care providers and adult consumers, from both Hispanic and non-Hispanic communities in the US. Based on the data, 48% of Hispanic while only 25% of non-Hispanic consumers believed that taking an antibiotic would cure their cold faster. Also, the majority of Hispanic adult consumers were obtaining their antibiotics from sources other than physicians (e.g., family members, friends, neighborhood grocery stores). Fifty four percent of health care providers believed that patients expect them to prescribe an antibiotic when they complain of cough and cold, while only 26% of all consumers had the same expectation.  Participating providers were discouraged from prescribing antibiotics because of the potential for resistance, side effects or allergic reactions, and cost. Moreover, knowledge of antibiotic resistance and their negative effects on the normal bacteria were lacking among the Hispanic consumers. The CDC believes improving access to health care might help reducing the risks of antibiotic self-administration, and also recommends public health initiatives to minimize inappropriate antibiotic use for Hispanic and other minority populations. The CDC encourages the use of their multilingual patient education programs such as “Get Smart: Know When Antibiotics Work” (http://www.cdc.gov/GetSmart/Community). If you are working with patients from diverse ethnic groups, do you see the same pattern in your community? How do you deal with antibiotic use and its challenges with your patients?

For additional information please visit CDC

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Did reports of side effects contribute to drop in bone drug use?

The Journal of Bone and Mineral Research recently published a study that examines effects of media reports on the use of oral bisphosphonates. Google trends were utilized to get data from 1996 to 2012 for the media reports; the Medical Expenditure Panel Survey and the National Inpatient Sample were used to obtain data regarding fracture outcomes in the United States. Researchers studied patients aged 55 years and older and those hospitalized for hip fractures. In 2008, 15.8% of women older than 55 were using bisphosphonates and in 2010, 1.9% of men used this category of agents. Despite a decade of bisphosphonates use and their effectiveness and lower safety risks concerns, a sharp decline (more than 50%) in their use was noticed between 2008 and 2012 corresponding with a series of media reports that highlighted a rare yet serious adverse effects of bisphosphonates. Series of spikes in Internet search activity for alendronate (Fosamax) occurred between 2006 and 2010 immediately after media reports. The decline in use was mostly noted among white women, rural residents and women with less than a high school degree. It occurred even though doctors and drug regulators did not make recommendations to stop the use. The negative reports about bisphosphonates overlooked the risk of fall-related injuries manifested by osteoporosis, or thinning bones. It is also possible that newer medicines for osteoporosis have contributed to this decline of the decades-old bisphosphonates. What are your thoughts about the methodology of this research, biophosphonates, and the findings?

For additional information please read Journal of Bone and Mineral Research

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Pioglitazone and cancer risk

The Journal of the American Medical association, recently published findings of a new cohort study aimed to examine the risk of pioglitazone and baldder cancer risk as well as additional cancer risks. The study focused on the usage, duration, cumulative dose and time of starting of pioglitazone therapy. Previously, pioglitazone studies suggested increased risk for bladder cancer. At the end of this observational analysis the researchers concluded that pioglitazone is not associated with a statistically significant increase risk of bladder cancer. The study also concluded that there was an increased risk for prostate and pancreatic cancer. However, more studies should be done to support findings. How often do you see pioglitazone prescribed and dispensed?

For more information please see JAMA

 

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Could Antibiotics Up Juvenile Arthritis Risk?

Juvenile arthritis is a disease that can be attributed to genetic factors as well as environmental factors. Researchers examined data from a British electronic record system, discovering 152 juvenile arthritis diagnoses made between 1994-2013 among children in the UK between age 1 and 15 years old. The study team suggests that antibiotics use can double the risk and a five prescriptions of antibiotics can triple the risk. Although this study can not conclude a cause and effect relationship, this study also suggests that those kids with juvenile arthritis may be already prone to developing more infections due to their lower immune system. What are your thoughts about the link between antibiotics and juvenile arthritis?

For more information please see  Webmed

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High blood pressure danger equal for slim and obese alike.

Studies in the past have shown normal weight or lean individuals with hypertension had a worse chance of developing stroke and heart failure. However, a new study of 3,657 men and women with no cardiovascular disease, cancer or diabetes prior to the study showed different results. The participants were divided into categories based on their weight circumference and BMI (underweight, healthy, overweight, obese and very obese). During the 10 years of the study participants were monitored for hospital admissions, procedures, cardiovascular disease or death every 9-12 month. At the end, researchers concluded those with healthy weight and no blood pressure problems were at low risk, while obese individuals with normal blood pressure were at greater risk. However, the presence of high blood pressure equally increased the risk for obese and healthy weight individuals. What are some of your favorite lifestyle recommendations for preventing/controlling high blood pressure?

For more information please see  Reuters

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Risk of intracranial hemorrhage linked to co-treatment with antidepressants and NSAIDs.

A retrospective cohort study looked at more than four million people in Korea who were taking an antidepressant with or without NSAIDS. Investigators found that patients who were on an antidepressant and an NSAID was added in the first 30 days of the treatment are at a higher risk for an intra-crainal hemorrhage. How will this affect the way you counsel patients who are starting an antidepressant?

For more information please see  BMJ

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