Efficacy of the 2015-2016 Flu Vaccine

Akpan Anani, Mercer University College of Pharmacy

According to the Centers for Disease Control and Prevention (CDC), the influenza vaccine may reduce the incidence of flu illness by up to 60% in the overall population. [1] Data from the 2015-2016 flu season estimates that 5.1 million influenza illnesses were avoided in the United States by virtue of vaccination. [1] Each year’s vaccine profile is chosen to select for the influenza viruses most likely to abound in that given season. [1] But due to the evolution of surface antigens on the influenza virus (antigenic drift), annual epidemics can occur—necessitating constant surveillance of the strains in circulation and changes to the makeup of the vaccine as needed. [2]

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The Effect of Intensive Lifestyle Interventions on Diabetes Type 2

Kenneth L. Smith, Mercer College of Pharmacy

Type 2 diabetes involves insulin resistance or the improper utilization of glucose when the cells fail to respond to insulin. Initial symptoms can involve frequent urination, increased thirst, and increased hunger. [1]  Other problems can involve heart disease, stroke, chronic kidney disease [2], foot ulcers [3], damage to the eyes, and many others.[4] First line treatment includes a combination of diet, physical activity, and weight loss in conjunction with pharmacological therapy.[5] It was pointed out that few studies have compared the effect of an intensive lifestyle intervention with the standard of care pharmacotherapy to maintain glycemic control in patients with type two diabetes.[6] In this randomized clinical trial, patients diagnosed with type two diabetes within the last ten years were treated then assessed for glycemic control using an A1c goal of 6.5%.[7]

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Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES)

Eku Oben, Mercer University College of Pharmacy

Macrolides have been used to treat asthma, but a review states that they are not better than placebo (OR 0.98, 95% CI 0.13 to 7.23) or steroids (OR 0.82, 95% CI 0.43 to 1.57) in treating asthma. [1] The asthma guidelines state that using daily long-term medications is the most effective way to control asthma. The recommendation is to use inhaled corticosteroids (ICS), leukotriene modifiers, long-acting beta agonists, combination inhalers, and theophylline as options to treat long-term persistent asthma. [2] However, the guidelines do not state the use of macrolide antibiotics, specifically azithromycin, for asthma. A review states that macrolides such as azithromycin may help reduce symptoms in patients with persistent asthma, as it helps improve lung function. [3]

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Praxbind® : Clinical Efficacy

Akpan Anani, Mercer University College of Pharmacy

While oral anticoagulants are used for the prevention or treatment of thrombotic events, certain life-threatening scenarios may warrant interventions in which anticoagulant reversal is needed to achieve hemostasis. Consequently, the availability and efficacy of reversal agents can have a large impact on the decision making of healthcare providers in regards to the anticoagulant therapy regimen being utilized by patients. Pradaxa® (dabigatran) is an oral anticoagulant approved in the U.S. in 2010 for the treatment and prevention of different thrombotic events. [1] Conversely, Praxbind® (idarucizumab) is an aptly named humanized monoclonal antibody fragment that binds to dabigatran and reverses its anticoagulant activity. [2] Idarucizumab has been licensed in numerous countries (first approved in the U.S. in 2015) [3] based on preliminary results from the first 90 patients enrolled in the Reversal Effects of Idarucizumab on Active Dabigatran (RE-VERSE AD) trial. [4]

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Angiotensin II for Refractory Vasodilatory Shock

Kenneth L. Smith, Mercer University College of Pharmacy

Vasodilatory shock is a medical emergency where the organs and tissues undergo a decrease in perfusion which can lead to organ failure and death if not treated immediately.  In this syndrome, a drop in blood pressure can occur despite preserved cardiac output. [1]  When intravenous fluid resuscitation fails to restore blood pressure, few choices are available other than vasopressors such as catecholamines (or other sympathomimetics) in addition to vasopressin.[2] However, these can be toxic at highdoses, and when these options fail, prognosis is considered poor.[3] Angiotensin II is a component of the renin-angiotensin –aldosterone-system (RAAS) which causes the release of anti-diuretic hormone (ADH), also known as vasopressin, from the posterior pituitary.[4] This leads to vaso-constrictive effects that can increase blood pressure. Consequently, use of angiotensin II for vasodilatory shock has been considered to provide a more natural physiological response to treat this serious condition.[5]

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Who is at Risk for Atherosclerotic Cardiovascular Disease

Meron Mezgebe, Mercer University College of Pharmacy

Elevated cholesterol increases the risk for developing atherosclerotic cardiovascular disease (ASCVD). [1] For the monitoring of cholesterol levels the American College of Cardiology and American Heart Association (ACC/AHA) recommend an initial lipid panel of patients 21 years or older, with no clinical ASCVD, and not currently on cholesterol-lowering drugs. The ACC/AHA statin benefit group assignment is made using patients’ age, comorbidities, 10-year ASCVD risk, and lipid panel. [2] A systematic review on lipid screening of younger adults (21-39 years) found no studies directly evaluating the effects of lipid screening versus no screening in younger adults. [3] The U.S. preventative services task force (USPSTF) recommends screening for lipid disorders in men 35 years or older and women 45 years or older, unless they have increased risk of coronary heart disease. [4] Continue reading

Risk of Hypertension Following Hypertensive Disorders of Pregnancy

Caitlin Register, Mercer University College of Pharmacy

Per the United States Preventive Services Task Force (USPSTF), preeclampsia affects approximately four percent of pregnancies in the United States, and is the second leading cause of maternal mortality worldwide. This condition may lead to stroke, eclampsia, and organ failure. The USPSTF recommends that blood pressure measurements be obtained during each prenatal care visit throughout pregnancy for screening purposes. [1] The American College of Obstetricians and Gynecologists suggests administration of daily low dose aspirin beginning in the late first trimester of pregnancy as a preventative measure for women at risk for preeclampsia. These include women with a history of early-onset preeclampsia with preterm delivery less than 34 weeks gestation and women with a history of preeclampsia in more than one prior pregnancy. For women diagnosed with gestational hypertension, preeclampsia, or superimposed preeclampsia, blood pressure monitoring is recommended at least 72 hours postpartum and again seven to ten days after delivery. [2] According to the American Heart Association, history of preeclampsia or pregnancy-induced hypertension may put women at risk for cardiovascular disease. [3]

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