McKenzie C. Ferguson

Current Therapies for Chronic Hepatitis C

Hepatitis C virus affects more than 180 million people worldwide and as many as 4 million people in the United States. Given that most patients are asymptomatic until late in the disease progression, diagnostic screening and evaluation should be performed in patients who display high‐risk behaviors associated with acquisition of hepatitis C. Chronic hepatitis C is associated with cirrhosis, hepatic failure, and death; therefore, treatment is aimed at reducing these complications, as well as improving quality of life and minimizing adverse effects. The American Association for the Study of Liver Diseases Practice Guidelines on the Diagnosis, Management, and Treatment of Hepatitis C represent the gold standard for guidance on the management of hepatitis C. Standard treatment for hepatitis C is peginterferon alfa in combination with ribavirin. Currently, two pegylated interferon products are approved by the U.S. Food and Drug Administration for the treatment of hepatitis C. The duration of therapy with peginterferon and ribavirin is dictated by viral genotype and virologic response. Additional therapies are under investigation for treatment of chronic hepatitis C and show early promise of comparative efficacy and fewer adverse effects. Special considerations in certain populations, including patients coinfected with human immunodeficiency virus, those with end‐stage renal disease, injection drug users, pregnant women, and pediatric patients, should guide treatment decisions.

Interferons as Therapeutic Agents for Infectious Diseases

This article explains the rationale for development of interferons as therapeutic agents, and describes commercial products available today. It also provides a summary of studies that have been performed with interferons for use as exogenous biological response modifiers in viral infections. Overall, the best data exist for treatment of viral hepatitis B and C, for which interferons are a cornerstone of therapy. Although infections with human papillomavirus and common cold viruses sometimes respond favorably to interferons, their outcomes are far from ideal. Finally, the role of interferons as vaccine adjuvants is still being explored but could be promising.

Survey Evaluation of Pharmacy Practice Involving Deaf Patients

Introduction: For a patient who is deaf, providing patient care can be more difficult due to communication barriers. This study was conducted in order to better understand pharmacists’ current means of communicating with deaf patients as well as investigating pharmacists’ knowledge of their legal responsibility to these patients. Methods: Surveys were used to gather information from pharmacists and were distributed in areas with a large population of deaf patients. Results: Of the 73 pharmacists who completed surveys, 50 (68.5%) of them interact with at least 1 to 5 deaf patients monthly. Pharmacists responded that accessibility of interpreters is the most significant barrier to communication and providing written material is the method most used to communicate with deaf patients. None of the 73 pharmacists who completed the survey felt that they have a legal obligation to provide and pay for an interpreter. Conclusion: When interacting with a deaf patient, pharmacists may experience communication barriers. Pharmacists should strive to appropriately communicate with the deaf as well as familiarize themselves with legal obligations to this patient population.

Do Sugar Substitutes Have Any Impact on Glycemic Control in Patients with Diabetes

Objective: To evaluate the impact of nonnutritive sugar substitutes on glycemic control in patients with diabetes. Data Sources: A comprehensive review of the literature was conducted in PubMed (1966-March 2012) and Scopus. A combination of MeSH terms and keywords were used, including acesulfame, aspartame, diabetes, neotame, rebiana, saccharin, stevia, and sucralose. Study Selection and Data Extraction: Clinical studies evaluating the impact of nonnutritive sweeteners on measures of diabetic control, including, but not limited to, blood glucose levels, postprandial blood glucose, and hemoglobin A1c were selected for review. Searches were limited to only nonnutritive sweeteners available in the US. Data Synthesis: Nine clinical trials that evaluated nonnutritive sweeteners in a total of 490 patients with diabetes were found. Doses of sweeteners in the studies varied from below acceptable daily intake levels for 3 consecutive days to daily dosing for up to 18 weeks and up to 3.5 times the acceptable daily intake levels. No significant differences in overall effects on glycemic control and insulin response were found. Conclusions: Nonnutritive sweeteners do not appear to affect glycemic control in patients with diabetes. Patients should be counseled to maintain an appropriate energy balance in their diet, with or without the use of nonnutritive sweeteners.

Persistent Post-Mastectomy Pain: Risk Factors and Current Approaches to Treatment

Persistent Post-Mastectomy Pain (PPMP) is a common condition that can follow surgeries for breast cancer, the most common cancer in women. Because of the frequency of PPMP and its potential severity, it has received increasing research attention. This manuscript reviews the recent research literature, beginning with a brief history and then relevant medical, surgical, demographic, and psychosocial risk factors. Subsequently, social, psychological, and functional sequelae that have been linked to PPMPS are considered, as is research on current pharmacological, psychological, and rehabilitative approaches to treatment. The review concludes with a discussion of directions for future research and treatment that might reduce the incidence and impact of PPMP on breast cancer survivors. PERSPECTIVE: This article describes current research literature involving mechanisms, risks, and treatments related to persistent post-mastectomy pain. Implications of research findings also are discussed for pre- and post-surgical approaches to pain management, current treatments, and promising research directions.

Drug information boot camp for pharmacy residents.

Drug information and literature evaluation skills are requirements for all pharmacy students completing a postgraduate year 1 (PGY1) ASHP-accredited residency.[1][1] All postgraduate year 2 (PGY2) ASHP-accredited residency programs also require residents to meet goals specific to drug information