Curbside Consult Volume 17, Issue 3 - Third Quarter 2019

Research Updates 

Primary care providers believe that comprehensive medication management improves their work-life
Sarah Shockley, PharmD, Fairview Pharmacy Services

Can comprehensive medication management services reduce provider burnout? Funk and colleagues interviewed primary care providers to determine their perspectives on clinical pharmacists embedded in their clinics.

A summary of the PIONEER 4 trial: Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes
Analisa Buysse, PharmD, Avera Marshall Regional Medical Center
Although GLP-1 agonists have clinical benefits, patients may refuse therapy because they are injections. Can an oral GLP-1 agonist offer the same benefits?

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy
Alicia Smith, PharmD, First Light Health System
Type 2 diabetes is the leading cause of kidney failure worldwide - will SGLT2 inhibitors be the drugs to prevent it? 

Therapeutic Thoughts

Use of psychoactive medications in older adults
Emily Hulke, PharmD, Goodrich Pharmacy
Psychoactive medications continue to be commonly used in older adults and could be contributing to falls. Do pharmacists have a role to play in reducing psychoactive medication burden in older adults? 

Updates in osteoporosis: the 2019 Endocrine Society Clinical Practice Guidelines   
Meg Tapp, PharmD, Essentia Health
One in two postmenopausal women will experience an osteoporotic fracture in their lifetime, leading to debilitating pain, reduced quality of life, and increased risk of mortality. Due to recent downward trends in bisphosphonate use and upward trends in hip fracture, the Endocrine Society published an updated set of guidelines for osteoporosis treatment. 

Pharmacotherapy options for treating opioid use disorder
Sara Maki, PharmD, Minnesota Community Care
Opioid use disorder (OUD) remains ever growing in the United States, yet treatment options remain underprescribed, partially due to unfamiliarity. This article will review three different treatments of OUD (methadone, buprenorphine, and naltrexone) to aid in treatment guidance. 

From the Pharmacy Press  

Potential role for pharmacogenomic testing in combating opioid epidemic
Anna K Hanson, PharmD, Essentia Health
Each year, opioid-related deaths continue to rise. Could pharmacogenomics be an innovative approach to fight the epidemic?

Doxycycline and tooth discoloration update: the tooth behind the matter
Kelly Beneke, PharmD, New Ulm Medical Center
The previous use of tetracyclines in pediatrics has been contraindicated in children younger than eight years old. An article from Stultz and Eiland investigates the evidence behind doxycycline use and permanent tooth discoloration and provides updated recommendations. 

Kratom use and toxicities in the United States
Tyler Stevens, PharmD, CentraCare Health- St. Cloud
Kratom use in the United States has gained popularity over the past few years with claims that it is a safe option for the treatment of pain, mood disorders, opioid use disorder (OUD) and opioid withdrawal. This report examines reported adverse effects and deaths associated with kratom.

Miscellaneous News  

Piecing together new Board of Pharmacy legislative changes
Monika Tawfik, PharmD, Hennepin Healthcare
New legislative changes regarding controlled substance prescriptions and other various topics enacted by the Board of Pharmacy are at the forefront of discussions between community pharmacists, patients, and practitioners.How do these rules affect pharmacists and what do you need to know?

Stronger warnings implemented for eszopiclone, zaleplon, and zolpidem
Brenda Shih, PharmD, Community University Health Care Center (CUHCC)
Eszopiclone, zaleplon, and zolpidem (“Z-drugs”) have a new boxed warning and contraindication regarding their use in certain patients. Will it change practice?

Talking prescription labels 
Sara Massey, PharmD, MOBE
Some pharmacies are attempting to improve medication safety for the visually impaired. As a pharmacist, how are you advocating for patients with low-vision or blindness? Read about one innovative way pharmacies are doing this! 

New Drug Update

Bremelanotide (Vyleesi™): a new treatment for hypoactive sexual desire disorder in premenopausal women
Jamie Erickson, PharmD, Cashwise Clinic Pharmacy/Carris Health
Bremelanotide (Vyleesi™): a new subcutaneous autoinjector for the treatment of hypoactive sexual desire disorder in premenopausal women - what does an ambulatory care pharmacist need to know?