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Episodes

ARCH Study: Is Romosozumab better than Alendronate for the Fracture-Prone?

2/16/2018
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It’s been 20 years since alendronate was approved to treat osteoporosis. Although effective, bisphosphonates aren’t ideal. Romosozumab is an investigational monoclonal antibody that increases bone formation and decreases bone resorption. Is romosozumab a potentially better alternative to bisphosphonate therapy? That’s what the ARCH study attempted to answer. Guest Authors: Yanqun Evonne Lee, MClinPharm and Joyce Yu-Chia Lee, PharmD Music by Good Talk

Duration:00:12:00

SPRINTing towards lower BP goals : A re-analysis of the ACCORD-BP trial

2/2/2018
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The new 2017 ACC/AHA guidelines recommend a BP goal of Guest Authors: Kevin Cowart, Pharm.D. and [...]

Duration:00:16:37

Therapy for Early-Stage COPD: What is the GOLDen Regimen?

1/19/2018
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Nearly 16 million adults in the United States have chronic obstructive pulmonary disease (COPD) but this is probably a woeful underestimate as many adults are asymptomatic in early stages. Screening is only recommended if patients exhibit symptoms and have risk factors. However, the most rapid decline in lung function occurs during GOLD stage 1. As COPD progresses, mortality, morbidity, and the economic burden increase very significantly. These facts suggest a need to detect and treat...

Duration:00:17:48

Inflammatory Statements about Cardiovascular Risk Reduction: The CANTOS Trial

1/5/2018
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We’ve all seen and used the American College of Cardiology 10-year atherosclerotic cardiovascular disease (ASCVD) risk calculator. There are several modifiable risk factors such as blood pressure, cholesterol, and smoking status that, if addressed, can lower ASCVD risk. But are there other modifiable risk factors that we are failing to account for and might be able to address? New evidence suggests systemic inflammation may be one. Guest Authors: Ian Hatlee, Pharm.D and Scott Pearson,...

Duration:00:13:16

Top Ten Things Every Clinician Should Know About the 2017 Hypertension Guidelines

12/15/2017
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We interview Eric MacLaughlin, Joseph Saseen, and Kristin Rieser about the ACC/AHA Guidelines for the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure in Adults released in November 2017. Dr. MacLaughin, a member of the Guideline Writing Committee, gives a insiders view of the guidelines development process and explains the rationale for lower blood pressure goals. Drs. Saseen and Rieser talk about some of the practical considerations that we all must consider as we...

Duration:00:19:29

Where is the COMPASS Taking Us? Rivaroxaban, Aspirin, or Both for Stable CVD ?

12/8/2017
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Since the introduction of direct oral anticoagulants (DOACs) less than a decade ago, use of this class has expanded beyond the prevention and treatment of venous thromboembolism and stroke prevention in the setting of atrial fibrillation. The potential role of DOACs in the secondary prevention of coronary artery disease (CAD) has been of considerable interest. In the setting of CAD, warfarin has resulted in significant more major bleeding when given either alone or in combination with...

Duration:00:18:48

Azithromycin to Prevent Asthma Exacerbations: What AMAZES Us and What Doesn’t

11/26/2017
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Despite good adherence to high-dose inhaled corticosteroids (ICS) and concomitant long-acting beta agonists (LABA), millions of people with asthma continue to experience exacerbations. What more can patients and clinicians do to reduce the risk of exacerbations? Does the routine use of antibiotics reduce the frequency of exacerbations? This is the question the recently published AMAZES study attempted to answer.

Duration:00:12:21

Painstaking Efforts to Improve Opioid Stewardship

11/10/2017
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Drug overdose is now the leading cause of death among Americans under the age of 50. In 2016, the United States (U.S.) Centers for Disease Control and Prevention (CDC) released a seminal guideline for primary care clinicians regarding opioid prescribing. These guidelines are now being implemented by clinicians, insurers, and healthcare institutions. The Transforming Opioid Prescribing in Primary Care (TOPCARE) study sought to assess the impact of a multicomponent care management...

Duration:00:16:25

Painting a New CANVAS for SGLT-2 Inhibitors?

10/13/2017
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While good glycemic control has been shown to prevent microvascular complications (e.g. retinopathy, nephropathy, neuropathy), only a few anti-diabetic agents have been shown to reduce macrovascular complications (e.g. cardiovascular events. Empagliflozin, a sodium glucose transporter-2 (SGLT2) inhibitor, not only reduced the risk of CV events but also all-cause mortality in the EMPA-REG OUTCOME study. Based on this data, the SGLT2 inhibitors were given favorable second-line treatment...

Duration:00:10:43

Validating HERDOO2 - When is it Safe to Stop Therapy After an Unprovoked VTE?

9/22/2017
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According to the 2016 CHEST VTE Guidelines, at least 3 months of therapy is recommended for an unprovoked DVT or PE (Grade 1B).Thereafter, the clinician is expected to weigh the risks and benefits to determine if extended therapy is appropriate. Balancing the risk of mortality from recurrent VTE versus major bleeding has been challenging. A validated clinical decision tool is sorely needed! Until recently, no risk assessment tool has been validated and therefore none have been widely...

Duration:00:14:47

Testing the Limits on Blood Glucose Monitoring: Can We Safely Cut Back?

9/8/2017
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Is self-monitoring of blood glucose (SMBG) cost-effective? SMBG is often recommended to help guide treatment decisions. Consumer-oriented advertising often promotes frequent SMBG as means to achieve better glycemic control but current clinical practice guidelines do not provide specific recommendations regarding the frequency of blood glucose monitoring. The lack of conclusive evidence supporting the clinical benefits of routine SMBG combined with the rising costs of healthcare has led...

Duration:00:13:50

Are Statins ALL THAT for Primary Prevention in Older Adults? A Second Look at ALLHAT-LLT

8/25/2017
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Statins reduce atherosclerotic cardiovascular disease (ASCVD) risk. However, the utility of statin therapy in older adults — particularly in those age 75 years and older — remains controversial. The need for additional evidence to guide clinical practice is underscored by the fact that one-in-three older Americans report taking a statin. Given the paucity of prospective data, a post-hoc analysis of the ALLHAT-LLT (Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial...

Duration:00:14:26

Wrapping up Knee Pain: Cabbage Leaf Wraps for Osteoarthritis of the Knee

8/11/2017
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Cabbage leaf wraps (CLWs) … the newest health craze trending on social media? A culinary masterpiece? Or an effective complementary treatment for osteoarthritis (OA) relief? A recently published study attempted to answer the latter question. Guest Author: Emily Prohaska, PharmD, BCACP, BCGP Music by Good Talk

Duration:00:10:30

All for One and FOURIER for All!

7/27/2017
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Although statins have a proven benefit and are widely used, ASCVD continues to be the leading cause of death in the US. In 2015, two proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, alirocumab (Praluent®) and evolocumab (Repatha®), were approved to treat elevated cholesterol when added to maximally-tolerated statin therapy in patients with familial hypercholesterolemia or history of ASCVD. However, the lack of long-term CV outcomes data, high cost, and uncertainty...

Duration:00:18:21

Vitamin D to Prevent Respiratory Tract Infections: Is the Evidence Dazzling or Disappointing?

6/26/2017
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Observational studies and systematic reviews have shown an association between low vitamin D concentrations and acute respiratory tract infections (ARTIs). An association is one thing, but can vitamin D supplementation reduce the risk of ARTIs? That’s what a recent systematic review and meta-analysis attempted to determine. Guest Author: Amanda Schartel, Pharm.D., BCACP Theme music by Good Talk

Duration:00:11:50

It’s All Relative: EINSTEIN CHOICE - Rivaroxaban for Extended Secondary Prevention of VTE

6/10/2017
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For the acute treatment of venous thromboembolism, the direct oral anticoagulants (DOACs) have increasingly replaced injectable anticoagulant therapy followed by warfarin. For patients with an unprovoked deep vein thrombosis or pulmonary embolism who may benefit from long-term extended prophylaxis for the secondary prevention of VTE, the choice is less clear. Should a DOAC be used? If so, which one and what’s the best dose? What about low-dose aspirin? Is extended therapy needed at all?...

Duration:00:15:01

Peeling Back the Layers on Coated Aspirin

4/14/2017
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More than 15 million Americans have coronary heart disease and most should be taking aspirin daily. Given aspirin’s ubiquity in cardiovascular medicine and patients’ pill boxes, it is shocking that there are still so many unanswered questions about aspirin use. Which dose and dosage forms should be prescribed? How common is aspirin resistance? What is the relationship between platelet inhibition and clinical outcomes? Guest Author: Daniela Valencia, Pharm.D. Theme Music by Good Talk

Duration:00:13:17

Antithrombotic Therapy Following Stent Placement in Patients with A-Fib: Should DOACs Be Preferred?

3/24/2017
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Many patients with atrial fibrillation (AF) received triple antithrombotic therapy after undergoing a percutaneous coronary intervention (PCI) and receiving cardiac stent. Triple therapy consists of warfarin plus dual antiplatelet therapy (DAPT) with a P2Y inhibitor and low-dose aspirin. But is triple therapy the best approach? This practice, while widely employed, is not entirely evidence-based. Moreover, the effectiveness and safety of the direct oral anticoagulants (DOACs) in this...

Duration:00:11:53

Getting Some SHUTi: Using the Internet to Treat Patients with Insomnia

3/13/2017
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Could automated, web-based cognitive behavioral therapy (CBT) replace flesh-and-blood healthcare practitioners? Can computers deliver healthcare at lower cost and similar quality to face-to-face interactions with humans? Several web-based CBT programs have been developed and are now being marketed directly to consumers. But do they actually work? Theme Music by Good Talk

Duration:00:12:22

Think Before You Make a RAS Decision: Evaluating the Use of RAS Blockers in Patients with Diabetes

2/24/2017
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Hypertension affects more than 70% of patients with type 2 diabetes mellitus and further increases the risk of cardiovascular disease in this high-risk population. While renin angiotensin system (RAS) blockers are clearly indicated in patients with heart failure, chronic kidney disease with proteinuria, and coronary artery disease (CAD), experts have come to different conclusions regarding their role as initial antihypertensive therapy for patients with diabetes. Theme Music by Good Talk

Duration:00:10:30

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