Levothyroxine For Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy

 

Roy Davenport, Mercer University College of Pharmacy

Conditions such as subclinical hypothyroidism and hypothyroxinemia may develop in pregnancy and can have major or fatal effects on the outcome of the fetus.  Cognitive dysfunction may occur in the offspring due to thyroid hormone deficiency, especially in the first trimester.  Clinical data was considered to be limited on the implementation of thyroid hormone replacement therapy during early stages of pregnancy would result in increased cognitive functioning in the offspring. [1]

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Gestational Diabetes: Does inducing labor really improve patient outcomes?

Azelia Brown, Mercer University College of Pharmacy

Gestational diabetes mellitus (GDM) is glucose intolerance beginning during pregnancy that is associated with an increased risk of complications including shoulder dystocia, fetal macrosomia, and morbidity. [1]  Induction of labor in the 38th or 39th week has been associated with reduced risk of complications but an increased risk of cesarean section (C-section) in nulliparous women.  It was expressed that the timing and mode of delivery that is best for this patient population is still unclear.  Current guideline recommendations for GDM labor management have been based on low quality evidence and, reportedly, there is no consensus on the best clinical management for these patients. [2]
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LEVO-CTS Trial: Should Cardiac Surgery Patients Use Levosimendan?

Sandy Liu, Mercer University College of Pharmacy

Utilizing a heart-lung machine, cardiopulmonary bypass replaces the heart’s pumping action and adds oxygen to blood, allowing the heart and lungs to be still prior to cardiac surgeries. [1]  Morbidity and mortality have demonstrated to be associated with this surgery, as is low cardiac output syndrome. [2]  Despite being managed with inotropic agents and mechanical cardiac assist devices, it has been suggested that short-term mortality is higher compared to patients without this syndrome. [3]  Some available inotropic agents may still have unknown safety profiles or known adverse effects.  [4]

Levosimendan is a calcium-sensitizing inotrope and an adenosine triphosphate (ATP) sensitive potassium channel opener used to enhance cardiac contractility and vasodilation.  This medication increases the sensitivity of cardiac myofilament to calcium, rather than increasing intracellular concentrations of free calcium.  By binding to cardiac troponin C in a calcium-dependent manner, levosimendan stabilizes troponin C and the kinetics of actin-myosin cross-bridges without increasing myocardial consumption of ATP. [5]

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Colectomy Patients with Ulcerative Colitis May Lead to Increased Risk of Gallstone Disease

Roy Davenport, Mercer University College of Pharmacy

Patients diagnosed with ulcerative colitis (UC) may undergo a colectomy if medical treatment fails.  A colectomy entails a resection of a short segment of the ileum.  This can cause malabsorption of bile acids and lead to a supersaturation of biliary cholesterol.  The increase in biliary cholesterol has been stated to increase the risk of symptomatic gallstones.  After a colectomy and with restorative proctectomy with ileal pouch-anal anastomosis (IPAA), bowel continuity restoration has been observed.  Eventually, the pouch may undergo colonic metaplasia and impair the reabsorption of primary bile acids leading to symptomatic gallstones. [1]

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The Opioid Tunnel

Shoshanna Robinson, Mercer University College of Pharmacy

The Centers of Disease Control and Prevention (CDC) guidelines on  prescribing opioids for chronic pain suggests that early opioid prescribing patterns for opioid-naïve patients increases the likelihood of long-term use. [1]  However, data is limited regarding the transition from acute to chronic opioid use.  The objective of this CDC morbidity and mortality report was to analyze the probability of long-term opioid use after an initial opioid prescription. [2] Continue reading

No Relief for Sciatica Sufferers

Dakota Thaxton Craft, Mercer University College of Pharmacy

Sciatica is leg pain that originates in the lower back and travels down the back of the leg as a result of irritation or compression of the sciatic nerve.  Symptoms may include tingling, numbness, or searing pain on one side of the buttock or leg.  These symptoms may be mild and infrequent or constant and debilitating.  Treatment strategies include providing pain relief and addressing the cause of symptoms. [1]

Lyrica® (pregabalin) is approved by the Food and Drug Administration for the treatment of neuropathic pain associated with diabetic peripheral neuropathy, spinal cord injury, and postherpetic neuralgia.  The onset of pain relief may occur as early as the first week of therapy. [2]

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Serious Monkey Business: New Promising Chimpanzee Vaccine For Ebola

Azelia Brown, Mercer University College of Pharmacy

In 2014, for the first time since 1976, the Ebola virus was declared an epidemic with a reported 28,616 cases and 11,130 deaths.  The 2014 Ebola epidemic highlighted the need for a vaccine, as the standard strategies (isolating patients, tracing contacts, and strategies for identifying patients) were not effective in containing the outbreak. [1]

The Ebola virus is classified as a filovirus and is associated with severe hemorrhagic fevers that can result in death. [2]  The wild-type glycoprotein, found in chimpanzees, has elicited an immune response while several other vaccines from clinical trials have displayed poor clinical efficacy. A shorter timeline was developed for the testing and approval of this vaccine due to the ebola epidemic. [3]

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