Senior Care Pharmacist最新文献_第8页

Chronic Pain Management in a CYP2D6 Poor Metabolizer: A Case Report for Oxycodone. CYP2D6 代谢不良者的慢性疼痛治疗：关于羟考酮的病例报告。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.137

Deepa Pednekar, Joshua Russell, Chandni Bardolia, David Thacker, Nishita Shah Amin

{"title":"Chronic Pain Management in a CYP2D6 Poor Metabolizer: A Case Report for Oxycodone.","authors":"Deepa Pednekar, Joshua Russell, Chandni Bardolia, David Thacker, Nishita Shah Amin","doi":"10.4140/TCP.n.2024.137","DOIUrl":"10.4140/TCP.n.2024.137","url":null,"abstract":"The objective of this case report is to illustrate pharmacogenomics (PGx)-guided oxycodone treatment, given the conflicting data on the analgesic response from oxycodone in Cytochrome P450 (CYP)2D6 poor metabolizers (PMs). PGx-guided therapy can help improve treatment outcomes. This case report describes a 58-year-old patient who was prescribed oxycodone for chronic pain management. The patient presented with a history of inadequate pain control despite analgesic treatment with oxycodone (morphine milliequivalent [MME] = 22.5). Pharmacogenetic testing revealed that the patient was a CYP2D6 Poor Metabolizer (PM), which may shed light on the observed lack of analgesic response to oxycodone. The clinical pharmacist recommended switching to an alternative opioid not metabolized via the CYP2D6 pathway. The patient was subsequently switched to hydromorphone (MME = 16), resulting in improved pain control and fewer side effects. The newer hydromorphone dose accounted for a 30% MME dose reduction. The patient's initial average and worst pain score were 7 and 9 out of 10, respectively, per the numeric rating scale (NRS). Upon follow-up with the patient in two weeks, her average and worst pain scores improved to 3 and 3.5 out of 10, respectively, per the NRS. Further PGx testing results led to an overall positive outcome, such as her willingness to participate in physical therapy as a result of improved pain scores. This case highlights the importance of considering individual variability in drug metabolism when prescribing medications, particularly opioids such as oxycodone, to ensure optimal therapeutic outcomes and minimize the risk of adverse events in CYP2D6 PMs.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 4","pages":"137-142"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Making Drug Therapy Safer and More Effective Is a Primary Concern for Pharmacists Everywhere. 让药物治疗更安全、更有效是各地药剂师关注的首要问题。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.127

Chris Alderman

引用次数: 0

Pharmacogenomics: Medical Advancement Caught in an Ethical and Policy Quagmire. 药物基因组学：陷入伦理和政策泥潭的医学进步。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.159

Leigh Davitian

引用次数: 0

Pharmacists' Role in Pharmacogenomics: Transforming Promise to Reality Through Perseverance and Knowledge. 药剂师在药物基因组学中的作用：通过毅力和知识将承诺变为现实。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.129

Manju T Beier

引用次数: 0

Utilizing Pharmacogenomics Results to Improve Statin-Associated Muscle Symptoms. 利用药物基因组学结果改善他汀类药物相关的肌肉症状。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.151

Coral Perez González, Chandni Bardolia, Katie Pizzolato, Nishita Shah Amin

引用次数: 0

Utilizing Pharmacogenomics Results to Guide Antidepressant Selection: A Case Report. 利用药物基因组学结果指导抗抑郁药物的选择：病例报告。

Senior Care Pharmacist Pub Date : 2024-04-01 DOI: 10.4140/TCP.n.2024.143

Nicholas Vernacchia, Nicole Del Toro-Pagán, Chandni Bardolia, Nishita Shah Amin

引用次数: 0

The Evolution and Revolution of Telehealth. 远程医疗的演变与革命。

Senior Care Pharmacist Pub Date : 2024-03-01 DOI: 10.4140/TCP.n.2024.123

Leigh Davitian

引用次数: 0

Success in Heart Failure? An Investigation of Heart Failure Readmission Rates and Medication Regimen Optimization. 心力衰竭成功了吗？对心衰再入院率和用药方案优化的调查。

Senior Care Pharmacist Pub Date : 2024-03-01 DOI: 10.4140/TCP.n.2024.113

Dominic Bracken, Sarah Wagner-Dallas, Destiny Branum

{"title":"Success in Heart Failure? An Investigation of Heart Failure Readmission Rates and Medication Regimen Optimization.","authors":"Dominic Bracken, Sarah Wagner-Dallas, Destiny Branum","doi":"10.4140/TCP.n.2024.113","DOIUrl":"10.4140/TCP.n.2024.113","url":null,"abstract":"In May 2022, the American College of Cardiology updated their guideline-directed medical therapy for congestive heart failure (CHF) to include four pillars of therapy. These pillars aim to better control patients with heart failure (HF) and reduce the incidence of hospitalization by including an evidence-based beta-blocker, an angiotensin-converting enzyme inhibitor/ angiotensin receptor blocker/angiotensin receptor/ neprilysin inhibitor, a mineralocorticoid receptor antagonist, and newly recommended sodium glucose cotransporter 2-inhibitors. This study at University of Florida Health Central Florida Hospitals reviewed patients who were diagnosed with CHF and recorded if they were readmitted with a HF exacerbation within 30 days of an initial index admission. Patients had data obtained retrospectively using electronic medical records from patient hospital encounters within the study inclusion dates; 7/1/2022-9/30/2022. Hospital readmission rates for patients with CHF, and information on each patient's medication regimen was collected to see if they met medication optimization criteria. A total of 252 patients were evaluated, with 157 meeting the inclusion criteria. Of the patients included, 23 (14.6%) experienced a hospital readmission within 30 days because of acute HF exacerbation or worsening HF. After reviewing medication regimens, 60 patients (38.2%) were receiving treatment with one pillar of therapy, 72 (45.8%) with two pillars of therapy, 12 (7.6%) with three pillars of therapy, and one patient was treated with all four pillars of therapy. In conclusion, this study showed that the recommended pillars of therapy are not being implemented and patients with CHF may benefit from medication optimization.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 3","pages":"113-122"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Use of Antipsychotics in Long-term Care: A Complicated Relationship. 长期护理中抗精神病药物的使用：复杂的关系。

Senior Care Pharmacist Pub Date : 2024-03-01 DOI: 10.4140/TCP.n.2024.95

Rob Leffler

引用次数: 0

Bereavement and Loss: Understanding Grief in Older People. 丧亲之痛与损失：了解老年人的悲痛。

Senior Care Pharmacist Pub Date : 2024-03-01 DOI: 10.4140/TCP.n.2024.98

Kirsten Werner, Jeannette Y Wick

{"title":"Bereavement and Loss: Understanding Grief in Older People.","authors":"Kirsten Werner, Jeannette Y Wick","doi":"10.4140/TCP.n.2024.98","DOIUrl":"10.4140/TCP.n.2024.98","url":null,"abstract":"Everyone experiences grief from time to time, but older people are more likely to experience grief simply because they live longer. Grief, bereavement, and mourning are different elements associated with death of a loved one. For most people, grief follows a fairly predictable trajectory, and over time resolves. One of the most used descriptions of grief was developed by Elizabeth Kubler-Ross and it is reviewed herein. However, for some people, grief becomes unbearable and chronic leading to prolonged grief disorder. For clinicians, it's essential to differentiate between prolonged grief disorder and major depressive disorder. Older people who experience unbearable grief often need medication to deal with some of its symptoms, which include depression, anxiety, hypertension, and lack of sleep. Older people also need considerable support as they deal with grief so that they do not become isolated, experience comorbidities, or spiral into physical and mental decline. Little specific research has examined pharmacists' opportunities to help older people who have prolonged grief, but some data suggest that these patients are more likely to visit the pharmacy and need medication more than others.","PeriodicalId":41635,"journal":{"name":"Senior Care Pharmacist","volume":"39 3","pages":"98-104"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0