Podcasts about drug interactions

Dr. Narda Robinson dives into the usage of cannabis for dogs with cancer, including:   Anti-inflammatory and pain control benefits  Potential anti-cancer effects  Concerns about long-term usage  The discussion also highlights the importance of product quality, potential herb-drug interactions, environmental considerations, and the legal constraints veterinarians face.   Dr. Narda Robinson shares her insights on when and how to use cannabis products effectively, including the importance of combining them with other integrative modalities for the well-being of the dog.  Your Voice Matters!   If you have a question for our team, or if you want to share your own hopeful dog cancer story, we want to hear from you! Go to https://www.dogcancer.com/ask to submit your question or story, or call our Listener Line at +1 808-868-3200 to leave a question.  Related Links:  Our CBD article: https://www.dogcancer.com/articles/supplements/cbd-for-dogs-with-cancer/   Check out our knowledgebase of supplements! https://www.dogcancer.com/supplements/  Chapters:  00:00 Introduction  00:13 Welcome to Dog Cancer Answers  00:38 Cannabis and Cancer: Anti-Inflammatory Benefits  02:48 Environmental Impact of Cannabis Cultivation  08:04 Using Cannabis for Dogs with Cancer  10:37 CBD and Drug Interactions  16:07 Non-Pharmacological Approaches to Healing  29:02 Legal Considerations for Veterinarians  35:55 Conclusion and Final Thoughts    Get to know Dr. Narda Robinson: https://www.dogcancer.com/people/narda-g-robinson-do-dvm-ms-faama/   For more details, articles, podcast episodes, and quality education, go to the episode page: https://www.dogcancer.com/podcast/   Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of PT Snacks podcast, host Kasey explores the importance of understanding common hypertension and cholesterol medications encountered in outpatient orthopedic settings. Kasey discusses the effects of beta blockers, ACE inhibitors, ARBs, calcium channel blockers, diuretics, and statins on patients' response to exercise. The episode covers potential side effects, red flags, and practical tips for physical therapists, highlighting the significance of a holistic approach to patient care. Additional resources and special offers through MedBridge are also mentioned.00:00 Welcome to PT Snacks Podcast00:56 Importance of Pharmacology in PT02:09 Understanding Blood Pressure Medications04:31 Cholesterol Medications and Their Effects05:34 Red Flags and Patient Management Tips06:51 Additional Resources and ConclusionRelevant MedBridge Courses1. Exercise and Drug Interactions by Kenneth L. Miller - Overview: Understand how various medications interact with exercise. Covers physiology, drug metabolism, and exercise prescription. 2. Pharmacology for Rehabilitation: Considerations for the Aging Adult by Andrew Opett - Overview: Explores the effects of drugs like antihypertensives and statins, especially in older adults.Support the showWhy PT Snacks Podcast?This podcast is your go-to for bite-sized, practical info designed for busy, overwhelmed Physical Therapists and students who want to build confidence in their foundational knowledge without sacrificing life's other priorities. Stay Connected! Never miss an episode—hit follow now! Got questions? Email me at ptsnackspodcast@gmail.com or leave feedback HERE. Join the email list HERE On Instagram? Find unique content at @dr.kasey.hankins! Need CEUs Fast?Time and resources short? Medbridge has you covered: Get over $100 off a subscription with code PTSNACKSPODCAST: Medbridge Students: Save $75 off a student subscription with code PTSNACKSPODCASTSTUDENT—a full year of unlimited access for less!(These are affiliate links, but I only recommend Medbridge because it's genuinely valuable.) Optimize Your Patient Care with Tindeq Looking for a reliable dynamometer to enhance your clinical measurements? Tindeq ...

Ten of the top herb-chemotherapy interactions. About Herbs website: https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search Also, search 'About Herbs' in your app store.

In this episode of "Next Steps 4 Seniors: Conversations on Aging," host Wendy Jones discusses the critical topic of medication management for aging adults. Wendy, along with an unnamed speaker, highlights the complexities and risks of managing multiple medications, including memory issues and pharmacy. They share real-life stories to illustrate the dangers of improper medication use and emphasize the importance of collaboration with healthcare providers. Wendy advises consulting pharmacists for potential drug interactions and maintaining updated medication records. The episode aims to provide practical tips to help families ensure the safety and well-being of their aging loved ones. Have questions or suggestions? Call 248-651-5010 or email hello@nextsteps4seniors.com. For podcast topics or sponsorship opportunities, contact marketing@nextsteps4seniors.com. Don’t forget to subscribe, follow, and share on your favorite podcast platform. Visit NextSteps4Seniors.com to learn more and explore additional resources. Let’s take the next steps together! This episode is proudly sponsored by Aeroflow Urology, a leader in incontinence care solutions. You may be eligible to receive your incontinence supplies at no cost through your insurance, delivered discreetly and directly to your door. *Some exclusions apply Visit aeroflowurology.com/ns4s to learn more and see if you're eligible.Learn more : https://nextsteps4seniors.com/See omnystudio.com/listener for privacy information.

Send us a message!In this episode Dana reviews how to study food the medications on the exam and key food/drug interactions to know. For a full review of the medications and supplements on the exam grab the Medications Bundle. This 3 part class includes Medications Review, Supplements Review and Practice Questions! See all tutoring options at https://www.danajfnutrition.com/tutoring

Taking multiple medications, called polypharmacy, is often a cause and contributor to health problems as we age. Seventy percent of people over 40 take at least one drug, twelve percent of people over 65 take ten or more prescription or nonprescription medications. And a whopping 95% of people older than 65 are taking a medication that increases their risk for falls. Dr. Fleming helps patients and providers understand what to watch for and provides simple tools for avoiding complications.   Key Takeaways To Tune In For: (01:08) - Understanding Polypharmacy (07:09) - The Risks of Blood Pressure Medications (11:11) - The Dangers of Drug Interactions (17:07) - Tips for Patients to Navigate Medication Reviews (21:14) - The Role of Advocates in Healthcare (25:05) - Recommended Resources for Healthy Aging     Resources talked about in this episode Guest website - Vital Aging Clinic

Dr. Sung Soo Kim, ID clinical pharmacist, presents a talk on the spectrum of HIV therapy and ART (Antiretroviral Therapy)-related adverse drug interactions. Dr. Kim begins by describing the mechanisms by which HIV therapy-related adverse drug interactions occur. Next, he discusses the various classes of antiretrovirals and their specific drug interactions, including integrate inhibitors, NNRTIs, NRTIS, and Protease Inhibitors. Dr. Kim closes by discussing the consequences of unmanaged drug-drug interactions in patients on ARTs as well as the available drug-drug interaction resources available to the clinician.

In this episode, Colleen F. Kelley, MD, MPH, and Jemma Samitpol discuss key considerations to improve the patient experience among transgender persons with HIV, including: Unique circumstances faced by transgender people trying to access HIV care (eg, stigma, discrimination)Best practices to improve access and linkage to HIV careWays to integrate gender-affirming care into HIV careCreating a welcoming and inclusive environmentOffering same-day HIV treatmentAddressing potential drug–drug interactions with gender-affirming hormone therapy (GAHT), including ART and natural remediesUnderstanding and communicating expectations of GAHT (eg, treatment response, timing of effects)Providing information on the safety of gender-affirming surgeriesImportance of providing person-centered care (eg, mental health, substance abuse, housing, harm reduction)Strategies on how to promote a gender-affirming environment (eg, wearing pronoun buttons, staff training)Consequences to the lack of gender recognition lawsHow to “be an ally” for transgender people with HIVPresentersColleen F. Kelley, MD, MPHProfessor of MedicineDivision of Infectious DiseasesDepartment of MedicineCo-Director, Emory Center for AIDS ResearchAssociated Dean for Research, Emory at GradyEmory University School of MedicineAtlanta, GeorgiaKritima Jemma SamitpolTangerine Clinic SupervisorInstitute of HIV Research and InnovationBangkok, ThailandGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast channel on Apple Podcasts, Google Podcasts, or Spotify.

Have you ever felt anxious about giving herbs to someone who's already taking medications? Many herbalists feel hesitant to help people taking prescribed drugs because of concerns about herb-drug interactions. But how much do we really need to worry about this?   Herbs can impact how drugs are absorbed and metabolized, which can actually be helpful at times, but very risky at other times. By understanding how herbs and drugs interact, you can feel confident in providing your clients with the care they need, even if they're taking medications.   In today's blog post, you'll learn: The 3 main ways herbs interact with drugs How herbs can impact the metabolism and absorption of drugs The exact method I use to avoid herb-drug interactions My top recommendations for herb-drug interaction resources     ———————————— CONNECT WITH SAJAH AND WHITNEY ———————————— To get free in depth mini-courses and videos, visit our blog at:  http://www.evolutionaryherbalism.com   Get daily inspiration and plant wisdom on our Facebook and Instagram channels: http://www.facebook.com/EvolutionaryHerbalism https://www.instagram.com/evolutionary_herbalism/   Be sure to subscribe to our YouTube Channel: https://www.youtube.com/channel/UCyP63opAmcpIAQg1M9ShNSQ   Get a free 5-week course when you buy a copy of the book, Evolutionary Herbalism: https://www.evolutionaryherbalism.com/evolutionary-herbalism-book/   ———————————— ABOUT THE PLANT PATH ———————————— The Plant Path is a window into the world of herbal medicine. With perspectives gleaned from traditional Western herbalism, Ayurveda, Chinese Medicine, Alchemy, Medical Astrology, and traditional cultures from around the world, The Plant Path provides unique insights, skills and strategies for the practice of true holistic herbalism. From clinical to spiritual perspectives, we don't just focus on what herbs are "good for," but rather who they are as intelligent beings, and how we can work with them to heal us physically and consciously evolve.   ———————————— ABOUT SAJAH ———————————— Sajah Popham is the author of Evolutionary Herbalism and the founder of the School of Evolutionary Herbalism, where he trains herbalists in a holistic system of plant medicine that encompasses clinical Western herbalism, medical astrology, Ayurveda, and spagyric alchemy. His mission is to develop a comprehensive approach that balances the science and spirituality of plant medicine, focusing on using plants to heal and rejuvenate the body, clarify the mind, open the heart, and support the development of the soul. This is only achieved through understanding and working with the chemical, energetic, and spiritual properties of the plants. His teachings embody a heartfelt respect, honor and reverence for the vast intelligence of plants in a way that empowers us to look deeper into the nature of our medicines and ourselves. He lives on a homestead in the foothills of Mt. Baker Washington with his wife Whitney where he teaches, consults clients, and prepares spagyric herbal medicines.    ———————————— WANT TO FEATURE US ON YOUR PODCAST? ———————————— If you'd like to interview Sajah or Whitney to be on your podcast, click here to fill out an interview request form.  

Welcome to the latest episode of Cardiology Digest, where we chart a course through groundbreaking studies that are shaping cardiology practice!   STUDY #1: First, we discuss the nuanced world of drug interactions involving diltiazem and direct-acting oral anticoagulants like apixaban and rivaroxaban. Tune in as we scrutinize the study's limitations and practical implications for your patients with atrial fibrillation.  Ray, WA, Chung, CP, Stein, CM, et al. 2024. Serious bleeding in patients with atrial fibrillation using diltiazem with apixaban or rivaroxaban. JAMA. 18: 1565–1575. (https://jamanetwork.com/journals/jama/article-abstract/2817546) STUDY #2: Next, we turn our attention to a case-control study examining the bleeding risks associated with the combination of selective serotonin reuptake inhibitors and anticoagulants in patients with atrial fibrillation. Are the bleeding risks substantial enough to rethink this combination therapy, or are there scenarios where the benefits outweigh the dangers? We'll leave no stone unturned. Rahman, AA, Platt, RW, Beradid, S, et al. 2024. Concomitant use of selective serotonin reuptake inhibitors with oral anticoagulants and risk of major bleeding. JAMA. 3: e243208. (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816687) STUDY #3: Finally, we explore a fascinating meta analysis that looked at renal denervation and its long-term efficacy in controlling blood pressure. See how renal denervation stacks up against traditional antihypertensive medications and what you need to consider when thinking about incorporating it into your treatment arsenal. Sesa-Ashton, G, Nolde, JM, Muente, I, et al. 2024. Long-term blood pressure reductions following catheter-based renal denervation: A systematic review and meta-analysis. Hypertension. 6: e63–e70. (https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.22314) Join us to explore the potential impacts of these studies, the ongoing debates they spark within the cardiology community, and to see how these findings could influence your clinical decisions. Learn more with these courses: Atrial Fibrillation Essentials (1 CME):  Pacemaker Essentials (5 CME) Pacemaker Essentials Workshop (1 CME) Get a Basic or Pro account, or, get a Trial account. Show notes: Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

Click here to send me your Q's, comments, lovenotes, or a quick message here :) This is a first my friends. I can't always answer Q's, especially in my DM's and emails, from listeners so I thought this would be a great way to share my answers (which always tend to be more nuanced than a quick response, let's be honest).If someone is asking these questions, my guess is that many more of you are too. So I hope you enjoy this grab bag of Q+A this week.First I share my thoughts on whether or not it's appropriate to work with "hormonally active" herbs at different phases in the menstrual cycle.Then I share some basics on how I navigate working with herbs when someone is on meds -- what the most important things are to consider, and how to think through this.After that, I share some quick thoughts on what to do if you have quirky sleep and still want to get an accurate read for your basal body temperature when cycle tracking. And finally I share a few simple tips to encourage an easier sleep onset for those who tend to get that "second wind" at night rather than actually get tired.I hope this is an enjoyable tour through these various topics. All the answers were totally off the cuff for me, so you'll hear my in-the-moment reflections. As I'm writing this, I'm feeling the vulnerability of trying something entirely new, *and* I'm also embracing the energy of playfulness today. So here it is, first ever Q+A. :)Listen to learn:are hormonally active herbs appropriate in different cycle phases (including menstruation)why it's important to take herbs regularly for hormonal health conditions (we're talking months at a time, not weeks)when I might make an exception and choose to work with herbs in specific phasessome basics on herb-drug interactions and what to look out forwhy consistency is more important than timing with your basal body temperature chartingseveral simple ideas you can easily incorporate into your daily routine to encourage sleepiness and reduce the chances of staying up til 2am (again!)Resources:Today's shownotes: Q+A with meEpisode 17: How stress messes with your hormonesEpisode 54: The many faces of chaste tree for "hormonal balance"Episode 86: Herbal spotlight on ashwagandhaFree guide: Start tracking your cycle with Fertility AwarenessIf you loved this episode, share it with a friend, or take a screenshot and share on social media and tag me @herbalwombwisdom.  And if you love this podcast, leave a rating & write a review! It's really helpful to get the show to more amazing humans like you.  ❤️DISCLAIMER: This podcast is for educational purposes only, I am not providing any medical advice, I am not a medical practitioner, I'm an herbalist and in the US, there is no path to licensure for herbalists, so my role is as an herbal educator. Please do your own research and consult your healthcare provider for any personal health concerns.Support the Show.

On this episode of the Real Life Pharmacology Podcast, I cover some of the most common food and supplement drug interactions. The 3 G's can potentially increase the risk of bleeding in patients on anticoagulants and antiplatelets. I discuss what supplements these are. There are some vitamins that can cause drug interactions. Vitamin C is a supplement that can alter the absorption of some medications. Metal cations like iron can bind certain medications and reduce absorption. I discuss which medications are most likely to be affected.

Jerry, a patient with type 2 diabetes, has been prescribed metformin to manage his blood glucose levels. The physical therapist understands that metformin's primary function is to: A) Stimulate the pancreas to produce more insulin. B) Decrease the liver's production of glucose. C) Increase the sensitivity of insulin receptors on cells. D) Slow the absorption of sugar from the intestines. LINKS MENTIONED: NPTE Tips & Tricks: www.nptegroup.com Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/meds Truelearn: USE CODE: PTH020 PT Hustle Phone Number: (727) 732-4573 --- Support this podcast: https://podcasters.spotify.com/pod/show/thepthustle/support

Today's sponsor of the Top 10 Anticoagulant Drug Interactions podcast is FreedAI. Freed listens, transcribes, and writes medical documentation for you. FreedAI is offering a discount exclusive to RLP listeners! Users will get $50 off their first month with Freed! Use the discount code: RLPPOD Apixaban is one of the most commonly used anticoagulants and there are some drug interactions you need to be aware of. Take a listen and find out! Warfarin concentrations can substantially be elevated by drugs that inhibit CYP2C9. I cover a few of them in my top 10 anticoagulant drug interactions.

Today's sponsor of the Top 10 SSRI Drug Interactions podcast is FreedAI. Freed listens, transcribes, and writes medical documentation for you. In this podcast episode, I discuss how to navigate SSRI drug interactions and identify some of the most common medications that have additive serotonergic activity. SSRIs have antiplatelet activity. I discuss how to navigate using other medications that may increase bleed risk in combination with SSRIs. Paroxetine and fluoxetine inhibit CYP2D6 I discuss how this can affect the benefits of tamoxifen therapy. Fluvoxamine is a nasty medication with regard to the number of and significance of drug interactions. I outline important fluvoxamine interactions in this podcast episode.

When you take a prescription medication, it goes into your body, does what it is supposed to and then leaves. Part of leaving the body often involves the medication getting broken down or metabolized by enzymes in the liver. One of the biggest medication metabolizing enzyme systems in the liver is called the Cytochrome P450 enzymes. Why should you care? Because cannabis can effect the Cytochrome P450 enzymes. That could cause there to be too much or too little of a prescription medication in your body to do its job properly. Dr. Lyndsey Anderson and her colleagues at the Lambert Initiative for Cannabinoid Therapeutics in Sydney, Australia have looked at how cannabis and the Cytochrome P450 enzymes interact. Let's have a listen!Lambert Initiative for Cannabinoid Therapeutics - web siteLyndsey Anderson - LinkedInMusic by:Emre Cords-Before We Decided to Fall -YouTube(Yes we got a SOCAN membership to use this song all legal and proper like)Additional Music:Desiree Dorion desireedorion.comMarc Clement - FacebookTranscripts, papers and so much more at: reefermed.ca

Many are using TCM alongside prescription COVID-19 drugs. But can these therapies mix safely? In this episode Dr. Skye Sturgeon, explores potential interactions between herbs and drugs, using the example of Paxlovid and Qingfei Paidu decoction. Learn how these treatments might work together or against each other, and discover resources for a deeper dive into COVID-19 therapies.You can access the written article here.  Select your favorite podcast provider to subscribe and get notified of new recordings!See our Monthly Practitioner Discounts https://www.mayway.com/monthly-specialsSign up for the Mayway Newsletterhttps://www.mayway.com/newsletter-signupFollow ushttps://www.facebook.com/MaywayHerbs/https://www.instagram.com/maywayherbs/

In this episode, we delve into the safety considerations of using broad-spectrum micronutrient formulas in mental disorder treatment, mainly how these supplements can interact with other medications. Is it safe to use these formulas alongside anesthesia during surgery? Faculty: Amelia Villagomez, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.75 CME: Broad-Spectrum Micronutrients (BSMs) for Mental Health: What You Need to Know for Clinical Use BSMs and Drug Interactions

On this episode, I discuss the pharmacology surrounding QTc prolongation and drug interactions. I discuss which medications are more likely to cause QTc prolongation and which patient populations we should be more concerned about. Antiarrhythmics are a common class of medication that can exacerbate QTc prolongation when used with other interacting medications. 500 ms is a common value utilized to help identify patients at risk for QTc prolongation and ultimately torsades de pointes.

In this episode, Dr. Bedimo discusses best practices for individualized care in transgender women living with HIV, including:Providing services in a gender-affirmative care modelProactive counseling on drug-drug interactions with gender-affirming hormone therapyStrategies to reduce adverse eventsPresenter:Roger Bedimo, MD, MS, FACPProfessor of MedicineInterim Director, Office of Global HealthUT Southwestern Medical CenterChief, Infectious Diseases SectionVA North Texas Health Care SystemDallas, TexasGet access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts, or Spotify.To download the slides: https://bit.ly/49zrnZsTo view the full online program:https://bit.ly/49x0W6D

On this week's episode of the Seekers of Meaning TV Show and Podcast, Dr. Stephen Goldfine, MD, chief medical officer of Samaritan Health and a palliative care physician, discusses how seniors can avoid adverse drug interactions, and the emerging options for palliative care. [Read more...] The post Seekers of Meaning 3/1/2024: Dr. Stephen Goldfine on Palliative Care, Guarding against Adverse Drug Interactions appeared first on Jewish Sacred Aging.

On this podcast episode, I discuss some of the most common antihypertensive drug interactions you need to know. One major interaction I discuss is the trifecta of a diuretic, an ACE or ARB, and an NSAID. This combination significantly increases the risk for acute renal failure. Nitrates aren't classically referred to as an antihypertensive but they can definitely cause some problems when combined with PDE5 Inhibitors. Lithium can interact with 3 blood pressure medication classes. ACEIs, ARBs, and diuretics can all increase the risk for lithium toxicity.

In this episode, Renslow Sherer, MD, and Trinh P. Vu, PharmD, BCIDP, discuss how to optimize the use of COVID-19 antivirals and how to navigate drug-drug interactions between COVID-19 treatments and a patient's home medications. Their discussion includes:Current COVID-19 landscapeCOVID-19 testing and vaccination recommendationsTreatment guidelines and antiviral options for nonhospitalized adults with COVID-19Resources for assessing and managing COVID-19 antiviral-related drug-drug interactionsAnswers to learners' most pressing questionsPresenters:Renslow Sherer, MDProfessor of MedicineSection of Infectious Diseases and Global HealthUniversity of ChicagoChicago, IllinoisTrinh P. Vu, PharmD, BCIDPClinical Pharmacy Specialist in Infectious DiseasesDepartment of PharmacyEmory University Hospital MidtownAtlanta, GeorgiaSlideset: https://bit.ly/4c6kwbJDownloadable resource:https://bit.ly/49rofP6Full program: https://bit.ly/3P16TR8Get access to all of our new podcasts by subscribing to the CCO Infectious Disease Podcast on Apple Podcasts, Google Podcasts or Spotify.

On this episode of the Real Life Pharmacology podcast, I take a dive into the most common mechanisms of drug interactions. Below I list some of the common drug interactions seen in practice and how they work! Opposing Effects Many drugs will work on various receptors throughout the body. To use as an educational point, there is no better example to point to than the beta receptor. Beta-blockers are frequently used in clinical practice for their ability to lower blood pressure and slow the heart rate. Both of these beneficial actions are primarily achieved by blocking the effects of beta-1 receptors. Some beta-blockers have action on alternative beta receptors. Propranolol is one such beta-blocker that is classified as a non-selective beta-blockers. This means that in addition to the positive effects on beta-1 receptors, it can also have blocking effects on beta-2 receptors. The blockade of the beta-2 receptor by propranolol can also be life-changing. It can directly oppose beta-2 agonists like albuterol from having their beneficial effects of opening up the airway. Enzyme Inhibition Medication metabolism is arguably the largest and most clinically significant source for drug interactions. Medications that are primarily metabolized by enzymes in the liver can be greatly affected if we affect how those enzymes work. CYP3A4 is one of the most well studied and well-known enzymes that can impact hundreds to maybe even thousands of drugs. Apixaban is an oral anticoagulant that is broken down at least in part by CYP3A4. By using a CYP3A4 inhibitor like erythromycin, there is the potential to raise concentrations of apixaban. This could lead to a higher risk of bleeding. Enzyme Induction Carbamazepine is a drug that you must know. This drug is a potent enzyme inducer. This differs significantly from an enzyme inhibitor and will have the exact opposite clinical effect. Drugs that are inactivated by liver enzymes will be inactivated more quickly in a patient taking an enzyme inducer. Going back to our prior apixaban example above, carbamazepine can induce CYP3A4 and facilitate a more efficient and swifter breakdown of the drug. Bleeding will be less likely. The risk for treatment failure, usually in the form of a blot clot, will be more likely.  Here's more information from the past on carbamazepine. Alteration in Absorption Binding interactions can be consequential and are one of the most common types of drug interactions. Many medications have the potential to bind one another in the gut. This can lead to lower concentrations of a specific medication. Calcium and iron are two of the most common examples of medications that can bind other drugs. Alteration in Protein Binding By remembering that unbound drug is an active drug, you should appreciate the risk for protein binding alterations. A significant number of medications can bind proteins in the bloodstream. As this occurs, that drug is not freely available to create physiologic effects. When another medication is added that can also bind these proteins, this can displace other medications and increase the quantity of free drug in the bloodstream. This essentially allows for enhanced physiologic effects. Warfarin is a medication that is highly protein-bound. When another drug is added that can kick warfarin off of those protein binding sites, it can free up warfarin which will increase the likelihood of elevating the patient's INR and increase their bleed risk. Alteration in Renal Elimination Some drugs can alter the way other medications are eliminated through the kidney. Chlorthalidone, like all thiazide diuretics, has the potential to block the excretion of lithium from the kidney. This can lead to lithium toxicity. This type of interaction, while significant, is much less common than drug interactions involve the liver and CYP enzyme pathways.   Effects on Transporters One of the last types of drug interactions is the effe...

In Season 2, Episode 2 of CLOT Conversations from Thrombosis Canada, Dr. Tzu-Fei Wang, an associate professor and hematologist, discusses a recent study titled "The prevalence of relevant drug-drug interactions and associated clinical outcomes in patients with cancer-associated thrombosis on concurrent anticoagulation and anticancer or supportive care therapies." The study aimed to investigate drug-drug interactions (DDIs) between anticoagulants and other medications in cancer patients and their impact on clinical outcomes.High Risk of DDIs: The study found that approximately 41% of cancer patients on anticoagulation therapy had relevant drug-drug interactions, particularly with antidepressants and certain other medications.Overall, the study highlights the importance of assessing and managing drug-drug interactions in cancer patients receiving anticoagulation therapy, while also suggesting that not all DDIs necessarily lead to adverse clinical outcomes. Collaborative efforts and larger data sets are needed to better understand and address this complex issue.Reference: Wang TF, Hill M, Mallick R, Chaudry H, Unachukwu U, Delluc A, Carrier M. The prevalence of relevant drug-drug interactions and associated clinical outcomes in patients with cancer-associated thrombosis on concurrent anticoagulation and anticancer or supportive care therapies. Thrombosis Research. 2023 Nov 1;231:128-34.  https://www.sciencedirect.com/science/article/pii/S0049384823002815 Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Credits: 0.50 AMA PRA Category 1 Credit™    CME/CE Information and Claim Credit: https://www.pri-med.com/online-cme-ce/Podcast/managing-drug-drug-interactions-non-hospitalized-patients   Overview: This in-depth discussion provides guidance on the options available to clinicians for managing potential drug-drug interactions in non-hospitalized patients with COVID-19. Hear practical strategies for increased monitoring, dosage adjustments, and exploring alternative medications to enable the safe use of anti-COVID-19 therapies. Faculty also discuss when consultation with a pharmacist and/or patient's specialist is advised. 

Find out from expert Dr Saye Khoo how to manage COVID-19 drug-drug interactions (DDIs).    Credit available for this activity expires: 10/20/2024 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/997480?ecd=bdc_podcast_libsyn_mscpedu

Omri Shor, Co-Founder and CEO of Medisafe is driven to help patients manage their medications. Omri emphasizes that medication adherence is influenced by various factors, including access to healthcare providers, ability to refill prescriptions, side effects, and cost. Medisafe tools support patients by providing reminders, tracking medication intake, and managing drug-to-drug interactions. Partners include drug manufacturers and pharma companies that want to support patients to improve outcomes. Omri explains, "People think medication management is one problem, but it is not. There are so many drivers and challenges behind it, and it is very personalized to the individual on one end. It's also aligned with the specific condition and the specific drug. There is no clear answer to who's more prone." "In many cases, what we want to see is actually connected to outcomes. So, if the patient takes a medication to get to a specific outcome, they can track those outcomes in Medisafe. There are roughly 70 or 80 trackers for blood pressure, glucose levels, SpO2, sleep, moods, etc. We will then use those trackers and allow patients to share that information with HCPs healthcare professionals, whether their pharmacist, nurse, or physician, so they can share this information with the right individuals to continue supporting them."   "We have recently concluded a study that looked at healthcare utilization. We saw patients with MS and epilepsy after starting to use Medisafe. We did a pre-post analysis and found that patients with epilepsy experienced a 36% reduction in ER visits. For patients with MS, we observed a 63% reduction in ER visits. The monetary implications were roughly between $4,500 and $6,000 in cost reduction per patient annually. So, better process management yields better outcomes, which was wonderful for us to observe at Medisafe." #Medisafe #MedicationAdherence #HealthLiteracy #DigitalHealth #MedicationManagement #DigitalCompanion medisafe.com Download the transcript here

Omri Shor, Co-Founder and CEO of Medisafe is driven to help patients manage their medications. Omri emphasizes that medication adherence is influenced by various factors, including access to healthcare providers, ability to refill prescriptions, side effects, and cost. Medisafe tools support patients by providing reminders, tracking medication intake, and managing drug-to-drug interactions. Partners include drug manufacturers and pharma companies that want to support patients to improve outcomes. Omri explains, "People think medication management is one problem, but it is not. There are so many drivers and challenges behind it, and it is very personalized to the individual on one end. It's also aligned with the specific condition and the specific drug. There is no clear answer to who's more prone." "In many cases, what we want to see is actually connected to outcomes. So, if the patient takes a medication to get to a specific outcome, they can track those outcomes in Medisafe. There are roughly 70 or 80 trackers for blood pressure, glucose levels, SpO2, sleep, moods, etc. We will then use those trackers and allow patients to share that information with HCPs healthcare professionals, whether their pharmacist, nurse, or physician, so they can share this information with the right individuals to continue supporting them."   "We have recently concluded a study that looked at healthcare utilization. We saw patients with MS and epilepsy after starting to use Medisafe. We did a pre-post analysis and found that patients with epilepsy experienced a 36% reduction in ER visits. For patients with MS, we observed a 63% reduction in ER visits. The monetary implications were roughly between $4,500 and $6,000 in cost reduction per patient annually. So, better process management yields better outcomes, which was wonderful for us to observe at Medisafe." #Medisafe #MedicationAdherence #HealthLiteracy #DigitalHealth #MedicationManagement #DigitalCompanion medisafe.com Listen to the podcast here

Exploring the science and data of microdosing, and briefing key drug interactions with the use of common used psychedelic therapies References: Cheung T. COMPASS Announces Positive Outcome of 25 mg COMP360 Psilocybin Therapy as Adjunct to SSRI Anti-depressant in Open-Label, Treatment-Resistant Depression Study. COMPASS Health. 13 Dec 2021 [press release]. Grinspoon P. The Popularity of Microdosing of Psychedelics: What Does the Science Say? Harvard Health. 19 Sept 2022. Gukasyan N, et al. Attenuation of Psilocybin Mushroom Effects During and After SSRI/SNRI Anti-depressant Use. Sage Journals. 2023 Jul; 37(7): 707-716 Malcolm B and Thomas K. Serotonin Toxicity of Serotonergic Psychedelics. Psychopharmacology. 2022;239: 1881-1891 Perez E, et al. The Psilocybin-Blunting Effects of SSRIs and Anti-depressants. Psychedelic Passage. 3 June 2022. Raison C, et al. Single Dose Psilocybin for Major Depressive Disorder. JAMA. 2023; 330(9): 843-853    

Welcome to Mastering Herbalism with Bob Linde of the Traditions School of Herbal Studies in Sunny Saint Petersburg FL Join us to explore the exciting world of herbal medicine.Todays episode is all about how to safely use herbs for your health.So let me start with a quote from one of my favorite herbalists, friend and teacher, David Winston….he once said that in his life herbs have really become popular….but not herbalists and that is a part of the problem. So I will discuss how to find an herbalist, quality control, formulation and very important for all of us trying to use to improve our health, herb and drug interactions, both positive and negative. As we journey together today about the joys of safe herbalism . If you have an herbal or health question you would like me to answer in a future episode, please email the show at traditionsherbschool@gmail.com and we will be sure to talk about it in one of the future episodes. If there is a guest you would like us to feature on the show please have them contact us as well. And remember you can also find me on https://www.youtube.com/@traditionsschoolofherbalst2184/featured and you can interact with me live on Facebook Live the last Friday of every month https://fb.me/e/11UUueZpsOf course, please consult your herbalist, ND, MD, AP or some other interesting set of letters for your personal health journey. And nothing I say is approved by any federal, state or local government agency and does not constitute medical advise…but your great grandmama would likely approve.

We miss potentially dangerous and even lethal drug interactions in EM more often than we realize. In this main episode EM Cases podcast with Dr. David Juurlink and Dr. Walter Himmel we review the common categories of drugs, the high risk patients and the key drug interactions that we need to know about in Emergency Medicine... The post Ep 184 Must Know Drug Interactions in Emergency Medicine appeared first on Emergency Medicine Cases.

In this VETgirl veterinary podcast, we interview Dr. Natalie Young, PharmD, BCSCP, FACVP about all things pharmacology and drug related in veterinary medicine. If you can't remember your pharmacology course, tune into this VETgirl podcast to learn some core pharmacological concepts, especially when it comes to drug interactions. (Cytochrome P450, anyone)? Tune in to learn about the activities of inducers and inhibitors in pharmacology, along with some of the top drug interactions we need to keep in mind for veterinary medicine. What about “additive drug interactions,” and how does this apply to us in the veterinary clinic. So think twice before you give that doxycycline (cheese, anyone?)!

Download for FREE today -  special Mnemonics Cheatsheet - so you can be SURE that you have that Must Know information down:  bit.ly/nursing-memory   Outline These Drugs Can Interact T-Theophylline D-Dilantin C-Coumadin I-llosone (Erythromycin) Description Coumadin and ilosone: Ilosone can increase the effects of Coumadin, increase risk for bleeding. Coumadin and Dilantin: potential for increased effects of both. Coumadin and Dilantin: Increased Coumadin metabolism (decreased effect). Theophylline and Dilantin: if taken orally they can interfere with absorption of each other and decrease medication effect.

Millions of Americans take dietary supplements, and most of us assume that they are safe. While that is probably a reasonable rule of thumb, there are some situations that require more vigilance. In particular, we need to beware of herb and drug interactions. Even your doctor may not know about the hidden harms. How Risky […]

This podcast features Dr. Todd Miano is a critical care pharmacist and renowned pharmacoepidemiologist who has dedicated his career to improving the safety and effectiveness of acutely ill patients. Dr. Miano has been a pioneer in research involving drug interaction effects and causality. His work has identified both interactions that may have been overhyped and ones that clinicians may not be as familiar with but should be. 

Today, we hear from a listener of the show, Paul R., who is a pharmacist of over 30 years. Paul sent in a great little segment where he talks through liver detoxification and kratom interactions. It is awesome and we can't wait for his next installment - thank you, Paul! None of the content in this or any episode of The Everything Kratom Podcast recommends or suggests that anyone should use kratom or any other substance in any way whatsoever. None of the content in this or any episode of The Everything Kratom Podcast constitutes medical claims or medical advice. Kratom is NOT intended to diagnose, treat, cure, or prevent any disease or condition. !!! GET A DISCOUNT ON ORDERS from Happy Hippo !!! Visit https://happyhippoherbals.com/r?id=ul2k1j and use the coupon code EVERYTHINGKRATOM at check out!     !!! GET A DISCOUNT ON ORDERS from ETHA Natural Botanicals !!! Visit https://ethalivefully.com/discount/EVERYTHINGKRATOM?aff=243 and use the coupon code EVERYTHINGKRATOM at check out! Please support this podcast with a small monthly donation here! https://anchor.fm/everything-kratom/support  Available wherever you get your podcasts: YouTube Channel: https://www.youtube.com/channel/UCUsCC1nBchi_xMX9wRyQ_nA Anchor - https://anchor.fm/everything-kratom Spotify - https://open.spotify.com/show/2fO3Xsx1BbNUs2rpXiQs3s Google Podcasts - https://www.google.com/podcasts?feed=aHR0cHM6Ly9hbmNob3IuZm0vcy82OWUxMzZjNC9wb2RjYXN0L3Jzcw== Apple Podcasts - https://podcasts.apple.com/us/podcast/everything-kratom/id1584592399 Pocket Casts - https://pca.st/mql8q14u RadioPublic - https://radiopublic.com/everything-kratom-WzkkBK Overcast - https://overcast.fm/itunes1584592399/everything-kratom Reason - https://reason.fm/podcast/everything-kratom?user=16e32b81-d623-4dcd-a000-623566fdc41a Website: https://everythingkratom279311648.wordpress.com Thank you all so much for listening! --- Send in a voice message: https://podcasters.spotify.com/pod/show/everything-kratom/message Support this podcast: https://podcasters.spotify.com/pod/show/everything-kratom/support

Oral anticancer medications are increasingly being incorporated into cancer treatment regimens and pharmacists may be encountering patients on these medications in their practices more frequently. This podcast episode will explore common questions that pharmacists may be asked about oral anticancer medications including potential interactions with other medications patients may be taking. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

In this episode, Patrick W. G. Mallon, MB, BCh, PhD, FRACP, FRCPI, discusses new data on COVID-19 presented at ECCMID 2023, including:Treatment in special populationsREDPINE: remdesivir in people with renal impairment hospitalized for COVID-19 pneumoniaRemdesivir and readmission for COVID-19 in immunocompromised patientsMolnupiravir vs nirmatrelvir plus ritonavir for COVID-19 with hematologic malignancyManagement of patients with severe diseaseRECOVERY: higher-dose vs standard-dose corticosteroids for hospitalized patients with COVID-19Real-world study of tocilizumab vs baricitinib for severe COVID-19Novel antiviralsEnsitrelvirBemnifosbuvir Novel vaccinesNB2155AZD2816/AZD1222qNIV/CoV2373GRT-R910NVX-CoV2373 in people with HIVFaculty:  Patrick W. G. Mallon, MB, BCh, PhD, FRACP, FRCPIProfessor of Microbial DiseasesCentre for Experimental Pathogen Host ResearchUniversity College DublinDublin, IrelandContent based on an online CME/CE program supported by independent educational grants from Gilead Sciences, Inc. and Novavax.  Link to full program: bit.ly/3niXGJ6Link to downloadable slides: bit.ly/3LUFejG

In this episode, Tracey Piparo, PA-C, and Renslow Sherer, MD, discuss cases of nonhospitalized patients with COVID-19, including:Young, healthy patient with no risk factorsYoung, healthy patient with risk factorsOlder patient with immunocompromiseOlder patient with renal dysfunctionPatient experiencing hypoxia Presenters: Tracey Piparo, PA-C Department of Palliative Medicine RJWBarnabas New Brunswick, New Jersey Renslow Sherer, MD Director, International HIV Training Center Professor of Medicine Section of Infectious Diseases and Global Health Department of Medicine University of Chicago Chicago, Illinois To download the slides: bit.ly/44cgH0qTo view the full online program: https://bit.ly/4201xcO

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: July 18, 2017 Things you need to know about the way antiepileptic drugs affect each other, all in one podcast. Take a few minutes here to familiarize yourself with these common and critical complications of seizure management. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. The content in this episode was vetted and approved by Danielle Becker. REFERENCES Pennell PB, Newport DJ, Stowe ZN, Helmers SL, Montgomery JQ, Henry TR. The impact of pregnancy and childbirth on the metabolism of lamotrigine. Neurology 2004;62(2):292-5. PMID 14745072 Pennell PB, Peng L, Newport DJ, et al. Lamotrigine in pregnancy: clearance, therapeutic drug monitoring, and seizure frequency. Neurology 2008;70(22 Pt 2):2130-6. PMID 18046009 Perucca E. Clinically relevant drug interactions with antiepileptic drugs. Br J Clin Pharmacol 2006;61(3):246-55. PMID 16487217 Petrenaite V, Sabers A, Hansen-Schwartz J. Individual changes in lamotrigine plasma concentrations during pregnancy. Epilepsy Res 2005;65(3):185-8. PMID 16084694 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Does risk level “C” always mean “continue”? Join us as we delve into the current state of immune checkpoint inhibitor drug interaction reporting in common drug information resources and discuss how these interactions may be interpreted in daily clinical practice. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

Episode 125: Non-opioid Chronic Pain Management Dr. Axelsson and Jesse explain how to treat chronic pain without opioids. Written by Anika Soleyn, MS4, Ross University School of Medicine. Edited by Jesse Lamb, MS3, American University of the Caribbean; Hector Arreaza, MD; and Fiona Axelsson, MD.This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Axelsson:Welcome to the first episode of 2023, Happy new year! Today is January 10, 2023.What is chronic pain?According to the International Association for the Study of Pain, chronic pain is nonstop or reoccurring pain that lasts more than 3 months or beyond the expected clinical course of illness. Chronic pain can adversely affect well-being and quality of life. We used to think of pain as a response to tissue damage, and as the tissue heals, the pain dissipates, but chronic pain is much more complex than that because there may be no evidence of tissue damage, yet the nociceptors keep sending signals to the brain that there is damage.There are 3 options for the management of chronic pain: non-pharmacologic, nonopioid pharmacological and opioid management. CDC recommends a combination of nonpharmacological and non-opioid management for chronic pain. The 7 most common chronic pain conditions are neuropathic pain, fibromyalgia or chronic pain syndrome, osteoarthritis, inflammatory arthritis, low back pain, chronic headache, and sickle cell anemia.Opioids in long-term care facilities.The use of opioids for the treatment of pain is common in the post-acute and long-term care setting. From the AFP Journal, the Choosing Wisely Recommendation states: “Don't provide long-term opioid therapy for chronic non-cancer pain in the absence of clear and documented benefits to functional status and quality of life.” The Society for Post-Acute and Long-Term Care Medicine published a statement in 2018 about the use of opioids. It states that the prescription of opioids should be based on an interprofessional assessment specifying why opioids are needed. When long-term opioids are not being used for cancer, palliative care, or end-of-life care in a long-term facility, a tapering plan must be “individualized and should minimize symptoms of opioid withdrawal while maximizing pain treatment with non-pharmacologic therapies and non-opioid medications”. Long-term opioid prescriptions should be reviewed regularly and take into consideration the potential harms of opioids. Clinicians are encouraged to offer alternatives such as behavioral therapy, non-opioid analgesics, and other non-pharmacologic treatments whenever available and appropriate.Initial assessment: Identify biopsychosocial factors and identify if the source is neuropathic, nociceptive, or central sensitization. This can be a challenging process and it may require several visits to determine the origin of pain. Neuropathic pain is due to nerve damage or irritation while nociceptive pain is due to tissue damage. Central sensitization is an abnormal response of the nociceptive system. There are changes in the nervous system that alter how it responds to sensory input that causes widespread pain with no apparent cause or in response to mild sensory input. Some examples include fibromyalgia, migraines in response to brushing hair, surgical scar pain, etc.Set goals and expectations: It is crucial to set up patient expectations if they have chronic pain. They should understand that pain can be improved to a manageable level but not always eliminated. Patients should have routine follow-up visits with education, and reassurance since they are shown to improve outcomes of pain management. Specific goals such as improved mobility and ability to do certain enjoyable tasks are more reasonable and specific goals than a goal of pain elimination. A good physician-patient relationship and clear communication are essential here. Patients could obviously become deeply upset at the prospect of pain that can't be eliminated, and those who have received opioids for their pain in the past could be even more distraught at the thought of not getting them now or needing to reduce their dose. The physician should be ready to have this discussion with their patients that have chronic pain and be ready to address their concerns appropriately. Reduce catastrophic thinking: Pain is an alarm system letting someone know there is some sort of damage. Because of this, it makes sense that a patient would respond to pain with anxious and catastrophic thinking. Patients who understand their own chronic diseases are more likely to be actively involved in their treatment, so understanding is crucial in the management of pain. Reducing fearful thoughts such as "there must be something wrong," and "hurt means harm'” is an important first step toward pain self-management and making sure the strategies attempted are effective.Rehabilitation: Focused pain clinics often include educational group classes for patients in distress. The programs include explanations for why pain might be present with no pathological factors. It also includes relaxation and mindfulness that help patients soothe themselves during attacks. The brain plays a big role in the experience of pain. Changing how your brain relates physical pain to stress and reducing those psychosocial barriers through self-care helps with pain management. Finding things that make you physically stronger like physical therapy or occupational therapy help, but also increasing mental strength by doing things that make you happy and having a quality social life is a strong determinant of how the brain perceives physical pain. Consistency is key in pain management even after the patient begins to feel better.Non-pharmacologic therapy – Most of what we will talk about today is non-pharmacological treatment. We will discuss the options and goals of different treatments. Chronic pain treatment should start with non-pharmacological approaches and then you can add medications if necessary. Again, these approaches aim to increase functionand reduce progression despite chronic pain. There should be a consistent non-pharmacological regimen, even if medications are added later. The three main approaches will be physical therapy, psychological therapy, and some integrative medicine methods.Physical therapy. The objective of physical therapy is to improve physical function. You should recommend programs that are specific for patients' limitations and the physical therapist should have trained specifically in chronic pain treatment. This ensures they do a proper initial evaluation and select appropriate therapeutic methods such as Therapeutic exercise: Sometimes patients can become so fearful of painful movement that they have deconditioned muscles. In the geriatric population, some patients are so afraid of falling, that they avoid any form of movement whatsoever, therefore almost certainly leading to falls due to deconditioning of those muscles. Adding small amounts of exercise as tolerated can begin to recondition patients and help them build strength. Patients with severe osteoarthritis are more likely to tolerate aquatic exercises. Therapeutic exercise programs may be available at the physical therapy facility or community centers. Patients can even find videos on the internet of tai chi, yoga classes, Pilates, and low-impact fitness programs. Exercise can certainly reduce pain and improve function, with few adverse effects but make sure patients tolerate the exercises and are not pushed beyond their limits. Stretching can also improve range of motion and strength, especially in chronic lower back pain patients. Psychological therapy:Cognitive-behavioral therapy. It is the most researched and recommended psychological treatment for chronic pain. It's normally recommended in conjunction with patient education, physical therapy, and exercise. CBT can be used after introducing meds and/or after surgery. There are 2 components to cognitive behavioral therapy: cognitions and behaviors. CBT addresses the way that patients' thoughts (cognitions) affect their actions and vice versa. This begins with helping patients identify situations and environments that trigger their pain and what they actually experience emotionally, behaviorally, and physically when they have pain.CBT addresses mental responses that may worsen pain, so patients learn to think about how they view their pain. To do this, they use a range of specific behavioral strategies such as relaxation and controlled-breathing exercises, activity pacing, pleasurable activities, improving their sleep, and cognitive reappraisal strategies, such as reframing negative situations to positive or practicing gratefulness.Complementary and integrative health therapies.-Mindfulness-based stress reduction. Mindfulness is the ability to be fully present where we are and what we're doing, and not be overly reactive or overwhelmed by what's going on around us.-Progressive muscle relaxation. For instance, tensing/relaxing muscles throughout the body along with positive imagery and meditation.-Biofeedback. During biofeedback, you're looking at biological signs, and feedback that is being correlated to physical sensations in your body to recognize the correlation between physical signs and symptoms of chronic pain. You're connected to monitors, such as electromyograms or electroencephalograms, to quantify muscle tension, brain waves, heart rate, and blood pressure to see how fluctuations and abnormal numbers physically feel in the body.-Massage therapy. It can relax painful muscles, tendons, and joints and relieve stress. The effect of pressure in certain areas that are tender causes relaxation and secretion of endorphins that can calm pains. That's why massage therapy can actually be addictive for some people, because of the endorphins. Another benefit of massage therapy is that it can help with improved absorption of medications due to improved circulation.There are many other integrative health therapies including Reiki, hypnosis, therapeutic touch, healing touch, and homeopathy. However, these are not well-researched and can't really be endorsed by evidence-based medicine.If patients are interested in trying complementary, integrative health therapy, you can guide them to practices that are at least safe. Some therapies can end up being harmful, such as herbal remedies or supplements with potential toxicities or known interactions with medications, so those should be taken cautiously. Make sure your med list while taking your history includes supplements and herbs patients might be trying. Shirodhara is an Ayurvedic approach to stress relief that involves having someone pour liquid — usually oil, milk, buttermilk, or water — onto your forehead.Herbal or plant-based treatments have also shown some efficacy in published studies. Ginger, turmeric, St John's Wort, and a handful of others seem like they could have some beneficial effects either on their own merit or as an adjunctive with other non-opioid therapies. Caution should be taken, though, as some of them, particularly St John's Wort, have been shown to have negative impacts on serum levels of opioids when used in combination with them due to their effects on the liver cytochrome system. Data is also rather mixed, with some studies showing reasonable efficacy and others showing almost none. If your patients want to take herbal supplements, it is essential to be diligent about checking their efficacy and interactions with other therapies to ensure safety. The physician should also be clear when discussing current medications to ask specifically if they take herbal supplements of any kind, as many patients don't consider these to be “medications” and will omit them during history. Of note, turmeric has to be taken with black pepper for better GI absorption.Weight reduction: A healthy diet and fitness are always recommended. Online guidelines are helpful on topics such as healthy fats, vegetables, avoiding refined sugar, and more. Obesity is a pro-inflammatory state, but it is important not to blame chronic pain problems solely on obesity since patients may still have pain after losing weight. Weight reduction can be a part of that plan, but we should not promise a cure for chronic pain after a patient reaches an ideal weight. Sleep disturbances: Ironically, sleep improves pain, but pain makes sleep more difficult. If patients complain of sleep disturbances, start with behavioral changes, including improved sleep hygiene (keep a regular sleep schedule, exercise regularly, don't use caffeine and caffeinated beverages, don't eat too late at night) and stimulus control (the bed should only be used for two things: sleep and sex, get out of bed if you can't sleep, wake up at the same time every day, and avoid bright screens before bedtime because they confuse your brain); cognitive behavioral therapy (deal with concerns or worries that may interfere with sleep). Treating sleep disturbance may have a positive effect on the treatment of chronic pain. Acupuncture: It involves the insertion of very thin needles through the skin at specific points on the body. Acupuncture is a key component of traditional Chinese medicine and can be considered in patients with chronic pain. There are significant difficulties in studying acupuncture, but randomized trials suggest that acupuncture and placebo may have similar efficacy, and both are superior to no treatment. Pharmacologic therapy – For patients with inadequate analgesia despite nonpharmacologic therapies, we add carefully selected multi-targeted pharmacological therapies based on the type of pain (i.e., nociceptive, neuropathic, central sensitization) For nociceptive pain, start with non-steroidal anti-inflammatory drugs (NSAIDs) while continuing non-pharmacologic treatments. If that doesn't work add a topical agent such as lidocaine, capsaicin, or topical NSAIDs. Consider opioid treatment if neither of those works. For neuropathic pain, start with antidepressants or antiepileptic drugs: tricyclic antidepressants, SNRIs, pregabalin, gabapentin, or carbamazepine in addition to non-pharmacologic therapy. If those medications do not provide relief of pain, then you can consider adding topical agents and then opioids after weighing the risk and benefits. Side effects can be viewed as harmful, but we can use them for our benefit.Opioids are reserved for people with moderate to severe pain who cannot function. Once you identify a treatment that works for the patient, follow-up visits should be continued to promote behavioral changes, monitor therapeutic response, and treat side effects. A pain contract should also be signed.Follow-up visits – Schedule follow-up visits to continue educating patients and their families and caregivers, to continue motivational interviewing, and to monitor improvement. Refer patients who are not making enough progress, such as not reaching goals of function and quality of life, to comprehensive pain programs that can use additional modalities such as injections.Bottom line: Non-pharmacologic options should be considered in the management of all patients with chronic pain. The main non-pharmacologic strategies include physical therapy, psychological therapy, and complementary and integrative therapy. Remember to treat sleep disturbances and obesity as part of your plan. Add pharmacologic agents such as NSAIDs, antidepressants, and anticonvulsants when non-pharmacologic therapies do not help the patient reach their goals. Consider opioids only in moderate to severe pain with loss of function. Opioid prescription is a complex topic that was addressed in episode 31 of this podcast, more than 2 years ago, it is time for an update. Stay tuned, we will talk about opioids soon.____________________________Conclusion: Now we conclude episode number 125, “Non-opioid Chronic Pain Management.” Non-pharmacologic therapy is proven to be effective in the treatment of chronic pain, especially physical therapy, psychological therapy, and some complementary therapy. Medications can be added to non-pharmacologic therapy, mainly NSAIDs, antidepressants, antiepileptic medications, and more. Opioids can be added in disabling chronic pain, but prescription needs to be done cautiously and watchfully. The treatment of chronic pain may be challenging and daunting at times, but fortunately, we have science to back us up with effective ways to help our patients. So, don't be discouraged and trust science! This week we thank Fiona Axelsson, Jesse Lamb, and Hector Arreaza. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________Links:Tauben, David, Brett R Stacey, Approach to the management of chronic non-cancer pain in adults, UpToDate. Last updated on May 06, 2022. Accessed January 10, 2023. https://www.uptodate.com/contents/approach-to-the-management-of-chronic-non-cancer-pain-in-adults.Choosing Wisely Recommendations: Don't provide long-term opioid therapy for chronic non-cancer pain in the absence of clear and documented benefits to functional status and quality of life, American Family Physician, Collections 460, American Academy of Family Physician. Link: https://www.aafp.org/pubs/afp/collections/choosing-wisely/460.html.What is Mindfulness? Mindful.org. https://www.mindful.org/what-is-mindfulness/.Jahromi B, Pirvulescu I, Candido KD, Knezevic NN. Herbal Medicine for Pain Management: Efficacy and Drug Interactions. Pharmaceutics. 2021; 13(2):251. https://doi.org/10.3390/pharmaceutics13020251.Royalty-free music used for this episode: “Good Vibes - Fashionista." Downloaded on October 13, 2022, from https://www.videvo.net/

Fernando Carnavali, MD; Rasika Karnik, MS, MD; Renslow Sherer, MD; and Joseph Torrisi, PharmD, BCIDP, discuss how to ethically prioritize patients for COVID-19 treatment when treatment supplies may be limited, including insights on:Risk stratificationMedication acquisitionDrug interactionsPresenters:Fernando Carnavali, MDAssociate Professor of MedicineDivision ChiefGeneral Internal MedicineDepartment of MedicineSite Director COVID Center of Excellence Satellite-Ansonia Mount Sinai Health New York, New YorkRasika Karnik, MS, MDAssistant ProfessorDivision of Primary CareDepartment of Internal MedicineUniversity of ChicagoMedical DirectorPost-COVID Recovery ClinicChicago, IllinoisRenslow Sherer, MDDirectorInternational HIV Training CenterProfessor of MedicineSection of Infectious Diseases and Global HealthDepartment of MedicineUniversity of ChicagoChicago, IllinoisJoseph Torrisi, PharmD, BCIDPClinical Pharmacy SpecialistInfectious Diseases PharmacyGrady Health SystemAtlanta, GeorgiaLink to slides: https://bit.ly/3hXMgIdLink to full program: https://bit.ly/3G271KL

Recorded live at the Midwest Herb Conference, May 2019. What are your experiences of interactions between herbs and drugs? My fifty years of practice have convinced me that such interactions are rare and are limited to certain types of herbs, prepared in particular ways, and used in specific circumstances.   

Dr. Ben Malcolm, PharmD, MPH, BCPP,  earned his bachelor's degree (BS) in pharmacology at the University of California at Santa Barbara, prior to his Masters in Public Health (MPH) and Doctorate of Pharmacy (PharmD) at Touro University California. He then completed post-graduate residencies in Acute Care at Scripps Mercy Hospital and Psychiatric Pharmacy at the University of California at San Diego Health. After residency training he obtained Board Certification in Psychiatric Pharmacy (BCPP). He began his career as an Assistant Clinical Professor at Western University of Health Sciences (WUHS), College of Pharmacy.Dr. Malcolm's interests focus on the intersection between psychiatric medications and psychedelic therapies. He has given several Continuing Education presentations to pharmacists and other healthcare professionals as well as published over a dozen articles in peer-reviewed literature relating to psychedelics or psychiatric medications. Currently he provides psychopharmacology consulting services and a resource and support membership relating to the use psychedelic and psychotropic medications via his site https://www.spiritpharmacist.comDr. Malcolm envisions a society in which access to psychedelic drugs in a variety of safe and supported settings is available for purposes of psychospiritual well-being, personal development, ceremonial sacraments, and treatment of mental illness. His vision guides his scholarship, education, and service-related professional activity.In this episode, Ben Malcolm and Beth Weinstein discuss …▶ The revelation that led Ben to call himself “The Spirit Pharmacist” ▶ All about Ben's online membership program▶ Ben's consulting work for people who need more individualized support▶ Psychedelic use in relation to antidepressants and benzodiazepines ▶ Why tapering off of psychiatric meds often takes as a long as six months to a year▶ The physiological safety of psilocybin▶ How the more psychiatric meds someone is on, the higher the risk of adverse reactions when using psychedelics▶ The need for much more research on psychedelic safety ▶ The risks of doing multiple psychedelic medicines in close proximity▶ The reality that death from psychedelics is extremely rare▶ The “Wild West” of psychedelics with respect to the safety of new compounds▶ Ben's rule of thumb about working with new compounds▶ The difference between phase 1, 2 and 3 trials▶ Issues of legality related to the use of analogues of scheduled substances▶ Ketamine as potentially habit forming and addictive, but also highly therapeutic if used safely with clear intention▶ How psychedelics uncover but don't necessarily solve the root cause of psychological symptoms▶ The real (if rare) occurrence of “miraculous” psychospiritual shifts and healings assisted by psychedelic useBen Malcolm''s Links & Resources▶ Website: https://www.spiritpharmacist.com/▶ Instagram: https://www.instagram.com/spiritpharmacist/▶ Facebook: https://www.facebook.com/spiritpharmacist▶ Linktr.ee and Email subscription: https://www.spiritpharmacist.com/link-tree▶ Free Gift: Antidepressant and Psychedelic Drug Interaction and Tapering Guide: https://www.spiritpharmacist.com/a/2147514915/hAiHsDMu

Finding long-term success in any industry is a feat in itself. In this episode, John Anderson shares how he found his decades of success in pharmacy as the owner of B&J Pharmacy and Wimberley Pharmacy. John always knew he wanted to be a pharmacist and had an idea that he wanted to own one. Three decades later, he's been the proud, happy, and proud owner of two small-town compound pharmacies that offer holistic healing options for the whole family. His secret - optimism. In his chat with host Steph Silver, John shares valuable insights into different topics such as compounding, drug interactions, health and aging. He also talks about how they managed the change in prescribing habits during the pandemic. Most of all, John explains how a positive mindset is key for a prosperous business and how to hiring for that disposition is also a valuable tool. Stay tuned!

Commentary by Dr. Valentin Fuster

In this episode, we review Paxlovid (nirmatrelvir/ritonavir) from the perspective of its pharmacology, efficacy, safety, pharmacists' authority to prescribe, drug interactions, and rebound symptoms after Paxlovid therapy. Key Concepts Paxlovid is the preferred outpatient therapy for COVID-19 in patients at high risk for progressing to severe COVID-19. It likely has similar efficacy to IV monoclonal antibodies and IV outpatient remdesivir but differences in vaccination rates and patient populations makes a direct comparison difficult. The 5-day course of Paxlovid is generally well tolerated. “Paxlovid mouth” (dysgeusia) is relatively common and is characterized by a terrible metallic or garbage-like taste in the mouth during therapy. As of July 2022, licensed pharmacists have the authority to assess patients for Paxlovid and prescribe the therapy; however, Medicare/Medicaid reimbursement has not clearly established how reimbursement of clinical services can occur. “Rebound” COVID-19 symptoms may or may not be due to Paxlovid (versus the natural course of the disease). If rebound symptoms occur, they are almost always mild or asymptomatic in nature and do not require additional treatment. References DailyMed - PAXLOVID- nirmatrelvir and ritonavir kit (nih.gov). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7bdddfba-bd31-44cb-ba9e-23a4e17a4691 Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19: Information for Healthcare Professionals. CDC. June 15, 2022. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html EPIC-HR Study: Hammond J, Leister-Tebbe H, Gardner A, et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med. 2022;386(15):1397-1408. doi:10.1056/NEJMoa2118542. https://www.nejm.org/doi/full/10.1056/NEJMoa2118542 COVID-19 Rebound After Paxlovid Treatment. CDC Health Alert Network. May 24, 2022. https://emergency.cdc.gov/han/2022/han00467.asp FDA Authorizes Pharmacists to Prescribe Paxlovid with Certain Limitations. Administration for Strategic Preparedness & Response (ASPR). July 6, 2022. https://aspr.hhs.gov/COVID-19/Therapeutics/updates/Pages/important-update-06July2022.aspx PAXLOVID Patient Eligibility Screening Checklist Tool for Prescribers. https://www.fda.gov/media/158165/download

[Rerun] Dr. Kirk Honda talks with Dr Robert Grubbs about the dangers of drug interactions. (Intro)The full episode is available to patrons of the podcast.Become a patron: https://www.patreon.com/PsychologyInSeattleEmail: https://www.psychologyinseattle.com/contactGet merch: https://teespring.com/stores/psychology-in-seattleDr. Kirk's Cameo: https://www.cameo.com/kirkhondaInstagram: https://www.instagram.com/psychologyinseattle/Discord: https://discord.gg/6QR4sE8x9KReddit: https://www.reddit.com/r/PsychologyInSeattle/Twitter: https://twitter.com/PsychInSeattleFacebook Official Page: https://www.facebook.com/PsychologyInSeattle/Facebook Fan Page (run by fans): https://www.facebook.com/groups/112633189213033The Psychology In Seattle Podcast ®Trigger Warning: This episode may include topics such as assault, trauma, and discrimination. If necessary, listeners are encouraged to refrain from listening and care for their safety and well-being.Disclaimer: The content provided is for educational, informational, and entertainment purposes only. Nothing here constitutes personal or professional consultation, therapy, diagnosis, or creates a counselor-client relationship. Topics discussed may generate differing points of view. If you participate (by being a guest, submitting a question, or commenting) you must do so with the knowledge that we cannot control reactions or responses from others, which may not agree with you or feel unfair. Your participation on this site is at your own risk, accepting full responsibility for any liability or harm that may result. Anything you write here may be used for discussion or endorsement of the podcast. Opinions and views expressed by the host and guest hosts are personal views. Although, we take precautions and fact check, they should not be considered facts and the opinions may change. Opinions posted by participants (such as comments) are not those of the hosts. Readers should not rely on any information found here and should perform due diligence before taking any action. For a more extensive description of factors for you to consider, please see www.psychologyinseattle.com