Family Medicine & Pharmacy Podcast

Management of Onychomycosis in Canada in 2014 http://www.ncbi.nlm.nih.gov/pubmed/25775640 Drug name: Brand: SA SA Criteria SA Approval period Direction SE Monitoring Ciclopirox 8% Penlac (nail lacquer) No Not covered N/A Nail lacquer: Apply bid to adjacent skin and affected nails daily. Remove with alcohol every 7 days (treat 4 weeks) dermatitis, dry skin, local burning sensation Efinaconazole […] The post Onychomycosis appeared first on Family Pharm Podcast.

We are back! (Or your money back!) In this episode, Billy and Tina discuss the PharmaCare coverage status of different classes of diabetes medications. Sources: BC PharmaCare Formulary: https://pcbl.hlth.gov.bc.ca/pharmacare/benefitslookup/ BC PharmaCare Special Authority: http://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/pharmacare/prescribers/special-authority CDA Formulary Listings for Diabetes Medications in Canada by provinces and territories (Jan 2016): http://www.diabetes.ca/getmedia/c87009a8-29b6-4061-a52a-963d0b077e47/pt-formulary-listing-jan-18-2016.pdf.aspx *In case the link doesn’t work: pt-formulary-listing-jan-18-2016 Class drugs Other therapeutic […] The post Diabetes Medications and BC Coverage Information appeared first on Family Pharm Podcast.

This is planned to be an 8-part series highlighting the take-home points I picked up during the St. Paul’s Hospital CME Conference 2014. Pearls from Part 1 “Internal Medicine”: Alcoholism – Dr. Paul Farnan Screen alcohol use disorders routinely to catch those of whom do not appear to have a significant social or occupational impairment. […] The post What I learned from St Paul’s CME 2014 Part 1 appeared first on Family Pharm Podcast.

After a 6-month hiatus, Tina – now a newly-hatched PHARMACIST! – and Billy teamed up to relaunch this pet project with a plan to make it more interactive and less sleep-inducing. Did it work with this unscripted episode? The post Family Pharm Podcast – RELAUNCHED! appeared first on Family Pharm Podcast.

Tina concentrates on the details of ADHD medications and invites your attention to the following: Non-pharmacological therapy behavioural therapy Stimulants methylphenidate amphetamines Non-stimulants atomoxetine clonidine other antidepressants and antipsychotics (to be covered in future episodes)   The post ADHD 2: medications appeared first on Family Pharm Podcast.

*This episode was recorded in January 2014. This is the topic that started it all. As Tina planned to study ADHD for school, we discussed how this would be useful information for other pharmacy students and medical trainees as well. We looked to the comprehensive CADDRA guideline for the assessment, differential diagnoses, and treatment strategies […] The post ADHD 1: CADDRA Guideline appeared first on Family Pharm Podcast.

Billy looked at the following guidelines to summarize the approach to a child with gastroenteritis:  UK NICE Guideline: Diarrhoea and vomiting in children under 5 (Issued: April 2009) http://guidance.nice.org.uk/cg84 CPS Guideline: Oral rehydration therapy and early refeeding in the management of childhood gastroenteritis (Posted: Nov 1, 2006) http://www.cps.ca/documents/position/oral-rehydration-therapy History: onset of diarrhea and/or vomiting (gastro is sudden in […] The post Gastroenteritis in Children appeared first on Family Pharm Podcast.

AAP Guideline on Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months http://pediatrics.aappublications.org/content/128/3/595.long UK NICE guideline: Urinary tract infection in children http://guidance.nice.org.uk/cg54 Summary: For children with fever, UTI should be suspected. For children at a very low risk for UTI, […] The post Pediatric UTI appeared first on Family Pharm Podcast.

The bulk of this episode is based on the UK NICE guideline: Feverish illness in children under 5, published in 2013. http://guidance.nice.org.uk/CG160 The guideline covers: Thermometers and the detection of fever Clinical assessment of the child with fever (using the traffic light system) Management by remote assessment Management by the non-paediatric practitioner Management by the paediatric specialist (investigations summarized […] The post Pediatric Fever appeared first on Family Pharm Podcast.

Antiplatelets: ASA Clopidogrel Anticoagulants: Warfarin Apixaban Dabigatran Rivaroxaban Clotting Cascade: Clotting Factor Song, by Emily Anne Nagler: Twelve, eleven, nine, it’s clotting factor time 8 and 9 to 10a 5, that’s how we stay alive Don’t forget to say: the tissue factor way 7 to 7a helps 10 go to 10a Then 2 to thrombin, […] The post A Fib 5: Antithrombotics appeared first on Family Pharm Podcast.

Tina discusses the following rhythm control medications for atrial fibrillation: Class 3 antiarrhythmics: blocks potassium channels and prolongs action potential duration Amiodarone Dronedarone Sotalol Class 1 antiarrhythmics: blocks sodium channels, which results in a slowed atrial conduction, lengthens atrial refractoriness, and suppresses automaticity propafenone flecainide Indiana University’s P450 Drug Interaction Table: http://medicine.iupui.edu/clinpharm/ddis/clinical-table/ References: CCS Guideline www.onlinecjc.ca/article/S0828-282X(12)00046-3/fulltext UptoDate uptodate.com  e-CPS www.e-therapeutics.ca/ RXFiles www.rxfiles.ca […] The post A Fib 4: Rhythm Control Medications appeared first on Family Pharm Podcast.

Tina discusses the following rate control medications for atrial fibrillation: Beta blockers Bisoprolol Metoprolol Atenolol Calcium channel blockers (non-dihydropyridines) verapamil diltiazem Digoxin   References: CCS Guideline www.onlinecjc.ca/article/S0828-282X(12)00046-3/fulltext UptoDate uptodate.com  e-CPS www.e-therapeutics.ca/ RXFiles www.rxfiles.ca Lexicomp www.lexi.com The post A Fib 3: Rate Control Medications appeared first on Family Pharm Podcast.

The CHADS2 and HAS-BLED predictive index are useful in assessing a patient’s thromboembolic risk and in predicting which antithrombotic therapy is most suitable; and that is either aspirin, clopidogrel, or anticoagulants. The 3 new anticoagulants may be simpler to use and may have less intracranial hemorrhage side effect than warfarin, there has been longer clinical […] The post A Fib 2: CCS 2012 Treatment Guidelines appeared first on Family Pharm Podcast.

Canadian Cardiovascular Society Atrial Fibrillation Guidelines 2010: Etiology and Initial Investigations http://www.onlinecjc.ca/article/S0828-282X(10)00016-4/fulltext CHADS2 Score http://www.mdcalc.com/chads2-score-for-atrial-fibrillation-stroke-risk/ HAS-BLED Score http://www.mdcalc.com/has-bled-score-for-major-bleeding-risk/ Mayo Clinic on A Fib http://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/basics/definition/con-20027014 The post A Fib 1: Etiology and Diagnosis appeared first on Family Pharm Podcast.

Tina revisits ACEI, ARB, BB, and Thiazides, which were covered previously with the hypertension episodes, and introduces a few new medications as well: Mineralocorticoid Receptor Antagonists: spironolactone and eplerenone Loop diuretic: furosemide Digoxin Vasodilators: hydralazine and isosorbite dinitrate For a quick summary of the CCS 2013 recommendations: ACE inhibitors: all asymptomatic patients with an EF […] The post CHF 2: medications appeared first on Family Pharm Podcast.

We turned our attention to chronic congestive heart failure (CHF) and reviewed “The 2012 Canadian Cardiovascular Society Heart Failure Management Guidelines Update“. National Institute of Health provided a great summary on CHF for patients and the public: http://www.nhlbi.nih.gov/health/health-topics/topics/hf/ For a basic anatomy review of the circulatory system: For another diagram showing the heart in relation to […] The post CHF 1: CCS 2012 Guideline appeared first on Family Pharm Podcast.

Classes of insulin and different treatment regimens are discussed in the third episode of a 3-part series on diabetes. This episode also marks the conclusion of our coverage of the “Big Three” of modern medicine (hypertension, dyslipidemia, and diabetes), and with it, we make an official announcement of the launch of the Family Pharm Podcast […] The post Diabetes 3: Insulin and Official Launch appeared first on Family Pharm Podcast.

We reviewed the CDA 2013 guidelines on antihyperglycemic therapy for type 2 diabetes (http://guidelines.diabetes.ca/executivesummary/ch13), and explored the pharmacological properties of each of the major classes: Biguanides: Metformin Sulfonylureas: chlorpropamide, gliclazide, glimepiride, glyburide, and tolbutamide Thiazolidinediones: pioglitazone and rosiglitazone Meglitinides: Nateglinide and repaglinide Alpha-glucosidase inhibitors: Acarbose Dipeptidyl Peptidase-4 inhibitors (DPP4 inhibitors): Saxagliptin and sitagliptin Glucagon Like Peptide-1 […] The post Diabetes 2: antihyperglycemics appeared first on Family Pharm Podcast.

To round up the “Big Three”, we turned out attention on diabetes. We reviewed the CDA guidelines on diabetes management and summarized the most relevant points that we think all family doctors and pharmacists would find interesting. http://guidelines.diabetes.ca/  The CDA also prepared many apps and calculators that help HCPs make clinical decisions. As well, there are […] The post Diabetes 1: CDA 2013 Guideline appeared first on Family Pharm Podcast.

We explore pieces of important evidence that offer a contrasting view on lipid control from the national guidelines. We are also introducing a new EBM resource available to CMA members: InfoPOEMs, which highlights clinical studies that the editorial team finds relevant.  http://www.cma.ca/clinicalresources/infopoems Treatment group Tools for Practice 2013: “Is Diabetes a Coronary Heart Disease Equivalent?” http://www.acfp.ca/Portals/0/docs/TFP/20131021_093004.pdf […] The post Dyslipidemia 4: EBM Special appeared first on Family Pharm Podcast.

We return to the topic of dyslipidemia and examined the: “2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults” http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a Previous episodes on statins can be found here. Major differences between AHA 2013 guideline and CCS 2012 guideline: CCS 2012 AHA 2013 Treatment Threshold LR (FRS

In this episode, we listed the life-style management of dyslipidemia and lowering cardiovascular disease risk, and dived into the main classes of medications for lipid lowering: statins, niacin, fibrates, resins, and cholesterol absorption inhibitors. As an important side note, the signs and symptoms of statin-induced myopathies were discussed as well. CCS 2012 guidelines: http://www.onlinecjc.ca/article/S0828-282X(12)01510-3 DASH diet […] The post Dyslipidemia 2: Lipid Lowering Medications appeared first on Family Pharm Podcast.

We covered the key points on risk stratification and treatment targets from the 2012 CCS guideline on dyslipidemia. We also briefly highlighted cardiovascular age and secondary causes of dyslipidemia. Below are a few useful links: 2012 Update of the Canadian Cardiovascular Society (CCS) Guidelines for the Diagnosis and Treatment of Dyslipidemia for the Prevention of […] The post Dyslipidemia 1: CCS 2012 Guideline appeared first on Family Pharm Podcast.

We reviewed some evidence on the treatment of hypertension that are contradictory to the CHEP 2013 guidelines summarized in our previous episodes. Salt restriction for hypertension CHEP 2013: 1500 mg of sodium per day is recommended for adults age 50 years or less; 1300 mg per day if age 51 to 70 years; and 1200 mg […] The post Hypertension 4: EBM Special appeared first on Family Pharm Podcast.