Don't accidentally overlook these trending pharmacy stories!
Don’t accidentally overlook these trending pharmacy stories!
When it comes to diabetes therapy, insulin is pharmacists’ most valuable weapon. Although oral therapies can offer convenience and reduce hypoglycemia risk, the glucose-lowering effects of insulin remain unrivaled.
Unfortunately, patients may resist starting insulin for many reasons, one of which is a fear of needles. Injecting insulin can be painful, especially when using longer needles. Painful injections are not only unpleasant for patients, but can also lead to medication noncompliance and poorer health outcomes.
Although longer needles are often prescribed for patients with increased body fat, this practice actually has no clinical basis. Insulin is meant to be injected into subcutaneous tissue; human skin is only 1.6 mm to 2.4 mm thick, on average. Because skin thickness doesn’t increase significantly in overweight and obese patients, a 4-mm needle is sufficient to deliver insulin to subcutaneous tissue in patients of all sizes.
Furthermore, choosing longer needles can negatively impact therapy in thinner patients. If patients inject insulin intramuscularly because their needle is too long, the drug’s absorption will be accelerated, while it’s duration of action will be shortened.
For patients with cystic fibrosis (CF), ibuprofen can help slow down lung function decline. The only problem is that consistent, high-dose ibuprofen use can lead to gastrointestinal bleeding, as well as kidney injury if taken with nephrotoxic intravenous antibiotics, which are commonly taken among CF patients.
The solution to this problem could be breathable ibuprofen.
The idea for developing inhaled ibuprofen originally came from Michael Konstan, MD, the pediatric department chair at Case Western University School of Medicine, who showed that patients with CF who received oral, high-dose ibuprofen (20 mg/kg, or 6 of the 200-mg tablets for a 60-kg person) were able to retain lung function and needed fewer courses of antibiotics. He also found that rats who took high-dose ibuprofen slowed the influx of the neutrophil into the lung, which provided an anti-inflammatory effect.
Carolyn L. Cannon, MD, PhD, associate professor of microbial pathogenesis and immunology at Texas A&M Health Science Center, is working in the preclinical phase of some nanoparticle formulations of this proposed therapy. She explained that Dr. Konstan’s Cystic Fibrosis Care Center at Rainbow Babies and Children’s Hospital still provides high-dose ibuprofen as a treatment option, but few other places do so because of potential adverse effects.
The American Heart Association (AHA) has released a scientific statement cautioning against the use of some common drugs and supplements in patients with heart failure (HF).
The statement published this month in Circulation said certain medications can cause heart-related problems by:
• Being toxic to heart muscle cells or changing how the heart muscle contracts.
• Interacting with HF medications, which means some of their benefits are lost.
• Containing more sodium than advised for patients with HF.
For example, commonly used nonsteroidal anti-inflammatory drugs, such as ibuprofen, can trigger or worsen HF by causing sodium and fluid retention and rendering diuretic medications less effective. Meanwhile, OTC heartburn medications and cold treatments may also contain significant amounts of sodium, which is normally restricted in patients with HF.
The AHA advised that many supplements can be dangerous for HF patients, including products containing ephedra, which is known to increase blood pressure, and others that interfere with one or more commonly used HF medications, such as St. John’s wort, ginseng, hawthorn, danshen, and green tea.
The Pharmaceutical Society of Ireland is censuring a pharmacist for poor professional performance. Pharmacist Jeremiah Blake, owner of Blake’s Pharmacy, will be “mentored” for a year by a superintendent pharmacist, and he will have to meet with that mentor at least 3 times during the 12-month period.
The Pharmaceutical Society of Ireland council found that Blake had poorly maintained a controlled drug register, prescription register, and pharmacy records, including records of medications dispensed. Blake was also rebuked for the lack of appropriate storage of human and veterinary medicinal products. For example, out-of-date products were not segregated from other items and were also not removed for disposal or destruction.
Medications that needed to be kept in cool temperatures were also not stored properly in the fridge. In addition, Blake did not keep medications stored in a clean or appropriate environment. The pharmacist also did not ensure that standard operating procedures were followed, and he did not provide a patient consultation area.
The pharmacist mentor will file reports on Blake’s solutions to these problems, and then the council will review all the reports at the end of the year to ensure that his behavior is satisfactory. If any of the reports do not satisfy the council, then Blake will continue to be monitored until the council is appeased.
In recent years, federal agencies have introduced significant regulatory proposals impacting different facets of the pharmaceutical industry, from drug manufacturing, to reimbursement, to disposal.
Here are 3 major proposals handed down from federal agencies that pharmacists should know:
1. CMS Final Rule on Outpatient Drug Reimbursement
2. FDA Draft Compounding Guidance
3. EPA Proposed Rule on Hazardous Waste Pharmaceuticals