iForumRx.org University of Mississippi School of Pharmacy - Division of Pharmacy Professional Development

Insulin pumps and continuous glucose monitors (CGM) have changed the standard of care for managing Type 1 Diabetes. A closed-loop system (also described as an artificial pancreas or automated insulin delivery system) consists of a CGM, an insulin pump, and a control algorithm that automatically calculates basal insulin delivery based on real-time glucose levels. Closed-loop insulin pumps may offer an opportunity to improve glycemic management while reducing some of the associated stress. However, there are limited data evaluating the safety and efficacy of this technology in children less than 14 years old.
Guest Authors:  Mary K Culp, PharmD and Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES
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Systemic inflammation appears to be an important contributor to atherosclerotic cardiovascular disease but, to date, no medications have been approved that specifically target systemic inflammation. Could colchicine, an anti-inflammatory drug that has been used for decades, move from “perhaps-do” to a “must-do” standard of care for patients with coronary artery disease (CAD)? Data from two previous trials have demonstrated colchicine’s positive impact on cardiovascular outcomes. The LoDoCo2 study asks us, again, to consider colchicine for patients with CAD.
Guest Authors:  Augustus (Rob) Hough, PharmD, BCCP and Taylor Huff, PharmD
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Patients with diabetes are 10 times more likely to experience lower limb amputations than the general population and amputations have very significant morbidity, mortality, and financial implications. While common risk factors for amputation in patients with diabetes include poor glycemic control, diabetic peripheral neuropathy, or peripheral arterial disease, canagliflozin use was implicated in the CANVAS and CANVAS-R trials. However, the CANVAS Program trials were not specifically designed to evaluate the risk of lower-extremity amputations.  Clearly, we need more information about the magnitude of risk when canagliflozin is used widely in a general population and who is at most risk.
Guest Authors:  Julie Dally, PharmD, BCPS, BCACP and Amanda Schartel, PharmD, BCACP
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There’s no denying that shared decision making (SDM) is an effective communication approach for making patient-centered medical decisions across a variety of health conditions. However, while tools for SDM are often useful during patient visits with practitioners, studies have yielded mixed results with regard to patient outcomes.  A new study explores the impact of a SDM tool for anticoagulation selection in patients with atrial fibrillation compared to standard care.
Guest Authors:  Ashley Meredith, PharmD, BCACP, BCPS, CDCES and Chandler Howell, PharmD
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Health care professionals often don’t think twice about adding a new medication when a patient is not at goal. But we’re reluctant to stop a medication for a chronic condition when the patient appears to be stable and doing well.  Polypharmacy in older adults is a significant problem.  It’s costly and increases the likelihood of adverse effects. Several observational studies have suggested that lower blood pressure and multiple antihypertensive medications may be harmful in the elderly. Is it possible to discontinue medications without causing serious harm?
Guest Authors: Keturah Weaver Pharm D, BCPS and Daniel Longyhore Pharm D, M.S., BCACP
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Sales of cannabinoid-containing products continue to rise. In 2020 it became a billion-dollar industry. With the increased use and popularity of CBD products, every clinician needs to critically appraise the evidence to determine if CBD should play a role in pain management and help educate patients about the potential risks.
Guest Author:  Alex R. Mills, PharmD, BCACP, AAHIVP
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