#pharmacists — Public Fediverse posts

@HI_Greens Indeed - that wouldn't surprise me at all! I can very well imagine the existence of #Neanderthals with that sort of #knowledge. If there were #Neanderthal #dentists, why not Neanderthal #doctors & #pharmacists? They probably didn't divide up the roles like we do.

@HI_Greens Indeed - that wouldn't surprise me at all! I can very well imagine the existence of #Neanderthals with that sort of #knowledge. If there were #Neanderthal #dentists, why not Neanderthal #doctors & #pharmacists? They probably didn't divide up the roles like we do.

https://www.europesays.com/ie/413257/ State to continue funding phased dispensing and blister packs for patients ‘who genuinely need them’ #BlisterPacks #DepartmentOfHealth #Éire #Health #HealthMinister #hse #IE #Ireland #Medication #MinisterJenniferCarrollMacneill #pharmacies #pharmacists

https://www.europesays.com/uk/862655/ State to continue funding phased dispensing and blister packs for patients ‘who genuinely need them’ #BlisterPacks #DepartmentOfHealth #Health #HealthMinister #HSE #Medication #MinisterJenniferCarrollMacneill #pharmacies #pharmacists #UK #UnitedKingdom

State Govt ‘exploring’ whether pharmacists should prescribe flu antivirals

The NSW Government could let pharmacists prescribe S4 antivirals for influenza, having already locked in pharmacist diagnosis and…
#NewsBeep #News #Medication #antiviral #CA #Canada #dermatology #GeneralPractice #government #Health #infectiousdiseases #influenza;flu #NSW #pharmacistprescribing #pharmacists #Pharmacology #pharmacy #PharmacyGuildofAustralia #pharmacypilot #Prescribing
https://www.newsbeep.com/ca/131781/

https://www.europesays.com/uk/409743/ State Govt ‘exploring’ whether pharmacists should prescribe flu antivirals #Antiviral #dermatology #GeneralPractice #government #Health #InfectiousDiseases #Influenza(Flu) #Medication #News #nsw #PharmacistPrescribing #pharmacists #pharmacology #pharmacy #PharmacyGuildOfAustralia #PharmacyPilot #prescribing #UK #UnitedKingdom

In 2022, NH #Republicans tried to pass a bill allowing #pharmacists to #dispense #Ivermectin over the counter as a cure for COVID.

I remember being surprised when that chipmunk #Sununu vetoed it.

These delusional #GOP crackheads are trying again, and since they hold majorities in all NH branches it will likely pass.

That fool #Ayotte serving as governor now will probably sign it, too.

You can forget about marijuana reform.

It's horse paste for #Republican horse asses.

In 2022, NH #Republicans tried to pass a bill allowing #pharmacists to #dispense #Ivermectin over the counter as a cure for COVID.

I remember being surprised when that chipmunk #Sununu vetoed it.

These delusional #GOP crackheads are trying again, and since they hold majorities in all NH branches it will likely pass.

That fool #Ayotte serving as governor now will probably sign it, too.

You can forget about marijuana reform.

It's horse paste for #Republican horse asses.

In 2022, NH #Republicans tried to pass a bill allowing #pharmacists to #dispense #Ivermectin over the counter as a cure for COVID.

I remember being surprised when that chipmunk #Sununu vetoed it.

These delusional #GOP crackheads are trying again, and since they hold majorities in all NH branches it will likely pass.

That fool #Ayotte serving as governor now will probably sign it, too.

You can forget about marijuana reform.

It's horse paste for #Republican horse asses.

In 2022, NH #Republicans tried to pass a bill allowing #pharmacists to #dispense #Ivermectin over the counter as a cure for COVID.

I remember being surprised when that chipmunk #Sununu vetoed it.

These delusional #GOP crackheads are trying again, and since they hold majorities in all NH branches it will likely pass.

That fool #Ayotte serving as governor now will probably sign it, too.

You can forget about marijuana reform.

It's horse paste for #Republican horse asses.

Dictator #DJT Revokes #Biden Exec Order ‘Lowering Prescription Drug Costs for Americans.’

Massively shifting impact immediately affects more than 6 million Californians on #Medicare and those #diabetics who get insulin capped at $35 a month.

“I was shocked,” said #California #Pharmacist Sonya Frausto.

If gov subsidies are gone, #pharmacists can no longer provide #medications at lower govt subsidized rates and the impact of the #health industry clusterfuck is immediate on US patients relying on these rates.

https://www.abc10.com/article/news/local/trumps-rollback-executive-order-prescription-prices/103-2b05e680-45fd-4c2b-b70b-567cad050ac3

Dictator #DJT Revokes #Biden Exec Order ‘Lowering Prescription Drug Costs for Americans.’

Massively shifting impact immediately affects more than 6 million Californians on #Medicare and those #diabetics who get insulin capped at $35 a month.

“I was shocked,” said #California #Pharmacist Sonya Frausto.

If gov subsidies are gone, #pharmacists can no longer provide #medications at lower govt subsidized rates and the impact of the #health industry clusterfuck is immediate on US patients relying on these rates.

https://www.abc10.com/article/news/local/trumps-rollback-executive-order-prescription-prices/103-2b05e680-45fd-4c2b-b70b-567cad050ac3

#Louisiana #hospitals and #pharmacists prep for new #abortionpill rules

https://www.washingtonpost.com/nation/2024/09/17/abortion-pills-louisiana-law-controlled-substances/

#MedicineShortages in #England ‘beyond critical’, #pharmacists warn

Survey has revealed challenges faced by pharmacists and risk of #HarmToPatients as key #drugs are unavailable

‘We’re firefighting in the background’: the pharmacists coping with record #DrugShortages
https://www.theguardian.com/society/article/2024/may/09/medicine-shortages-in-england-beyond-critical-pharmacists-warn
#ToryPiciesInAction #BrexitBonus #Health #PublicHealth #ToryIndifference
#CommunityPharmacyEngland #CPE

#MedicineShortages in #England ‘beyond critical’, #pharmacists warn

Survey has revealed challenges faced by pharmacists and risk of #HarmToPatients as key #drugs are unavailable

‘We’re firefighting in the background’: the pharmacists coping with record #DrugShortages
https://www.theguardian.com/society/article/2024/may/09/medicine-shortages-in-england-beyond-critical-pharmacists-warn
#ToryPiciesInAction #BrexitBonus #Health #PublicHealth #ToryIndifference
#CommunityPharmacyEngland #CPE

#MedicineShortages in #England ‘beyond critical’, #pharmacists warn

Survey has revealed challenges faced by pharmacists and risk of #HarmToPatients as key #drugs are unavailable

‘We’re firefighting in the background’: the pharmacists coping with record #DrugShortages
https://www.theguardian.com/society/article/2024/may/09/medicine-shortages-in-england-beyond-critical-pharmacists-warn
#ToryPiciesInAction #BrexitBonus #Health #PublicHealth #ToryIndifference
#CommunityPharmacyEngland #CPE

#MedicineShortages in #England ‘beyond critical’, #pharmacists warn

Survey has revealed challenges faced by pharmacists and risk of #HarmToPatients as key #drugs are unavailable

‘We’re firefighting in the background’: the pharmacists coping with record #DrugShortages
https://www.theguardian.com/society/article/2024/may/09/medicine-shortages-in-england-beyond-critical-pharmacists-warn
#ToryPiciesInAction #BrexitBonus #Health #PublicHealth #ToryIndifference
#CommunityPharmacyEngland #CPE

#MedicineShortages in #England ‘beyond critical’, #pharmacists warn

Survey has revealed challenges faced by pharmacists and risk of #HarmToPatients as key #drugs are unavailable

‘We’re firefighting in the background’: the pharmacists coping with record #DrugShortages
https://www.theguardian.com/society/article/2024/may/09/medicine-shortages-in-england-beyond-critical-pharmacists-warn
#ToryPiciesInAction #BrexitBonus #Health #PublicHealth #ToryIndifference
#CommunityPharmacyEngland #CPE

My new story for the Medical Post/Canadian Healthcare Network.
#Doctors and #pharmacists in Canada can log on for free. Here are a few paragraphs.

Could a century old treatment be an answer to antibiotic resistance?
In a first in Canada, a patient with an #antibiotic resistant artificial joint infection has received treatment with phage therapy and is showing promising early responses.

“This is cutting edge stuff, and a potentially new technology,” said Dr. Marisa Azad, the infectious diseases physician who treated the patient. She is also an assistant professor of medicine at the University of Ottawa.

The patient presented with severe periprosthetic joint infection (PJI) in the summer of 2023. She had already undergone multiple surgeries and had experienced several relapses and infections with the same persistent bacteria.

“She’d been on multiple very prolonged courses of antibiotics and had a severe drug allergy to two major drug classes of antibiotics. I was extremely limited in what I could use to treat her,” Dr. Azad told the Medical Post in an interview.

That’s when the idea arose of trying an experimental treatment course with phage therapy. The team got approval for doing the experimental treatment from Health Canada, and worked with Winnipeg-based Cytophage, which supplied the phages.

“We developed a protocol and gave her therapy over two weeks while she was admitted to hospital. She’s completed her therapy. Now we’re monitoring her closely and giving her adjunctive antibiotics,” she said.

The idea didn’t come out of the blue. In the medical literature, a study from just last year in Clinical #Infectious Diseases provided a review of 33 previously published cases of patients with end-stage, refractory bone and joint infections (BJI) who underwent treatment with phage therapy. The authors found that from those case reports, “29 (87%) achieved microbiological or clinical success, two (5.9%) relapsed with the same organisms, and two (5.9%) with a different organism” with no serious adverse events.

The conclusions of that paper stated there were “important advantages, disadvantages, and barriers to the implementation of phage therapy for BJIs.” Yet, at the same time, the authors added they, “believe that if phage therapy were to be used earlier in the clinical course, fewer cumulative antibiotics may be needed in an individual treatment course.”

The word phage is short for #bacteriophage, a word coined in 1917—literally meaning bacteria-eater. They are viruses whose lifecycle depends on certain types of bacteria.

“They latch on to specific types of bacteria and inject their genetic material into the bacterial cell." Dr. Azad explained. "They take over the bacterial cells’ machinery to produce more little viruses inside and explode or burst open the bacteria,” releasing viral particles that can go and infect other cells of the same type of bacteria.

Intriguingly, each #phage targets a specific type of #bacteria...
The story of phages started over 100 years ago. They were independently discovered, first in 1915 by a British pathologist, Frederick Twort, and then again in 1917 by French-Canadian microbiologist Felix d’Herelle. And...

#MedMastodon #IDmastodon #microbiology @medmastodon
https://www.canadianhealthcarenetwork.ca/could-century-old-treatment-be-answer-antibiotic-resistance

We go a brochure in the mail from #BlueCross of #Massachusetts in the mail, telling us that in July the list of covered medicines (formulary) will shrink.

As a household with some important prescriptions, I worry we'll lose coverage. But, the brochure also tells us that the list of medications lost won't be available until end of May.

So, I'll have 45 days to worry if I'll be impacted, and then another 30 days until I'm actually impacted.

Spouse brought up a good point: Feels like if I can only buy into a service on an annual basis, the terms shouldn't significantly change within the same year.

Why is it that the #insurance company can change the plan details mid-year, but I can't change the plan we're on, or the insurance provider, until the next enrollment period?

#pharmacists #America #enshittification #law #bullshit #HealthCare

Ontario expands pharmacist prescription powers, adding 6 more common ailments | CityNews Toronto https://bit.ly/3F3pUgl #OntarioPharmacies #Pharmacists #Prescribing #OCPInfo #onpoli @ontariogreens @onpoli

Gout update.
For #doctors and #pharmacists in #Canada. An overview I wrote for The Medical Post/Canadian #Healthcare Network.

"Refresher on #gout: the only curable arthritis
Often only seen in crisis, patients with gout can be cured with the right treatment and follow-up.
By Pippa Wysong

Gout is the most common inflammatory arthritis, yet it is frequently underdiagnosed, misdiagnosed and often mistreated.

Yet, according to rheumatologist Dr. Jean-Philip Deslauriers, once patients are on the right treatment, it’s the only arthritis where a cure can be achieved.

“With other arthritis conditions, the goal is remission. But with gout one can get rid of the underlying disease and attain a cure,” he said. Dr. Deslauriers is a clinical professor of #medicine at the University of Sherbrooke and spokesperson for the Arthritis Society of Canada (ASC).

“Gout is easy to treat, and most cases can be managed by family #doctors,” told the Medical Post in an interview. Gout is a painful #arthritis caused by elevated levels of serum uric acid (UA), hyperuricaemia.

Prolonged hyperuricaemia (which is generally asymptomatic and can be present for years) leads to the deposition of monosodium urate crystals in synovial fluid and other body tissues. Eventually, neutrophils will venture into the joint to try to destroy the crystals (partly unsuccessfully) but end up triggering an episode of painful inflammation—a gout crisis in which patients present with inflamed, painful and swollen joints. Often, but not always, the affected joint is in the foot or ankle, especially the first metatarsophalangeal joint.

Crystals can also be deposited in other tissue and sometimes break through the skin creating yellowish-white nodules called tophi.

There are several reasons why gout can be missed. One is that symptoms are intermittent and it can take years for crystals to build up inside joints. A patient may present to an outpatient clinic or ER where acute symptoms are treated with colchicine, #NSAIDs, cortisone infiltration or prednisone for their acute crisis, and then sent home and told to see their family physician for follow-up.
Crisis and oft missed opportunity

But a crisis, in the early stage of the disease, tends to last for only three or four days. By the time patients see an FP, they feel fine and may not mention it—if they even have access to an FP.

“Often there is only management for the crisis itself. If we don’t address the underlying cause which is too much uric acid in their blood, crises will happen again, more intensely and more frequently. And the disease will affect more joints. Over time this can lead to deformity and erosion, possible crystal formation in soft tissue called tophi,” Dr. Deslauriers said.

According to the 2018 recommendations for gout by the European League Against Rheumatism (EULAR), several features need to be taken into account for a diagnosis. These are: monoarticular involvement of a foot or ankle joint; previous acute episodes; rapid onset of severe pain and swelling; erythema; being male and associated #cardiovascular diseases, plus hyperuricaemia.

For a definite diagnosis, crystals need to be seen in synovial fluid or tophus aspirates.

Both the EULAR and American College of Rheumatology (ACR) guidelines state that once gout is confirmed, treatment to lower UA levels can start even while the patient is in crisis

“This is a very important point because if not done when the patient is assessed during his acute crisis, it often isn’t done at all,’’ Dr. Deslauriers said...."

The rest of the story is on the site. Sorry, password protected for people in Canadian healthcare.

#MedMastoson #rheumatology

https://www.canadianhealthcarenetwork.ca/refresher-gout-only-curable-arthritis

Gout update.
For #doctors and #pharmacists in #Canada. An overview I wrote for The Medical Post/Canadian #Healthcare Network.

"Refresher on #gout: the only curable arthritis
Often only seen in crisis, patients with gout can be cured with the right treatment and follow-up.
By Pippa Wysong

Gout is the most common inflammatory arthritis, yet it is frequently underdiagnosed, misdiagnosed and often mistreated.

Yet, according to rheumatologist Dr. Jean-Philip Deslauriers, once patients are on the right treatment, it’s the only arthritis where a cure can be achieved.

“With other arthritis conditions, the goal is remission. But with gout one can get rid of the underlying disease and attain a cure,” he said. Dr. Deslauriers is a clinical professor of #medicine at the University of Sherbrooke and spokesperson for the Arthritis Society of Canada (ASC).

“Gout is easy to treat, and most cases can be managed by family #doctors,” told the Medical Post in an interview. Gout is a painful #arthritis caused by elevated levels of serum uric acid (UA), hyperuricaemia.

Prolonged hyperuricaemia (which is generally asymptomatic and can be present for years) leads to the deposition of monosodium urate crystals in synovial fluid and other body tissues. Eventually, neutrophils will venture into the joint to try to destroy the crystals (partly unsuccessfully) but end up triggering an episode of painful inflammation—a gout crisis in which patients present with inflamed, painful and swollen joints. Often, but not always, the affected joint is in the foot or ankle, especially the first metatarsophalangeal joint.

Crystals can also be deposited in other tissue and sometimes break through the skin creating yellowish-white nodules called tophi.

There are several reasons why gout can be missed. One is that symptoms are intermittent and it can take years for crystals to build up inside joints. A patient may present to an outpatient clinic or ER where acute symptoms are treated with colchicine, #NSAIDs, cortisone infiltration or prednisone for their acute crisis, and then sent home and told to see their family physician for follow-up.
Crisis and oft missed opportunity

But a crisis, in the early stage of the disease, tends to last for only three or four days. By the time patients see an FP, they feel fine and may not mention it—if they even have access to an FP.

“Often there is only management for the crisis itself. If we don’t address the underlying cause which is too much uric acid in their blood, crises will happen again, more intensely and more frequently. And the disease will affect more joints. Over time this can lead to deformity and erosion, possible crystal formation in soft tissue called tophi,” Dr. Deslauriers said.

According to the 2018 recommendations for gout by the European League Against Rheumatism (EULAR), several features need to be taken into account for a diagnosis. These are: monoarticular involvement of a foot or ankle joint; previous acute episodes; rapid onset of severe pain and swelling; erythema; being male and associated #cardiovascular diseases, plus hyperuricaemia.

For a definite diagnosis, crystals need to be seen in synovial fluid or tophus aspirates.

Both the EULAR and American College of Rheumatology (ACR) guidelines state that once gout is confirmed, treatment to lower UA levels can start even while the patient is in crisis

“This is a very important point because if not done when the patient is assessed during his acute crisis, it often isn’t done at all,’’ Dr. Deslauriers said...."

The rest of the story is on the site. Sorry, password protected for people in Canadian healthcare.

#MedMastoson #rheumatology

https://www.canadianhealthcarenetwork.ca/refresher-gout-only-curable-arthritis

Gout update.
For #doctors and #pharmacists in #Canada. An overview I wrote for The Medical Post/Canadian #Healthcare Network.

"Refresher on #gout: the only curable arthritis
Often only seen in crisis, patients with gout can be cured with the right treatment and follow-up.
By Pippa Wysong

Gout is the most common inflammatory arthritis, yet it is frequently underdiagnosed, misdiagnosed and often mistreated.

Yet, according to rheumatologist Dr. Jean-Philip Deslauriers, once patients are on the right treatment, it’s the only arthritis where a cure can be achieved.

“With other arthritis conditions, the goal is remission. But with gout one can get rid of the underlying disease and attain a cure,” he said. Dr. Deslauriers is a clinical professor of #medicine at the University of Sherbrooke and spokesperson for the Arthritis Society of Canada (ASC).

“Gout is easy to treat, and most cases can be managed by family #doctors,” told the Medical Post in an interview. Gout is a painful #arthritis caused by elevated levels of serum uric acid (UA), hyperuricaemia.

Prolonged hyperuricaemia (which is generally asymptomatic and can be present for years) leads to the deposition of monosodium urate crystals in synovial fluid and other body tissues. Eventually, neutrophils will venture into the joint to try to destroy the crystals (partly unsuccessfully) but end up triggering an episode of painful inflammation—a gout crisis in which patients present with inflamed, painful and swollen joints. Often, but not always, the affected joint is in the foot or ankle, especially the first metatarsophalangeal joint.

Crystals can also be deposited in other tissue and sometimes break through the skin creating yellowish-white nodules called tophi.

There are several reasons why gout can be missed. One is that symptoms are intermittent and it can take years for crystals to build up inside joints. A patient may present to an outpatient clinic or ER where acute symptoms are treated with colchicine, #NSAIDs, cortisone infiltration or prednisone for their acute crisis, and then sent home and told to see their family physician for follow-up.
Crisis and oft missed opportunity

But a crisis, in the early stage of the disease, tends to last for only three or four days. By the time patients see an FP, they feel fine and may not mention it—if they even have access to an FP.

“Often there is only management for the crisis itself. If we don’t address the underlying cause which is too much uric acid in their blood, crises will happen again, more intensely and more frequently. And the disease will affect more joints. Over time this can lead to deformity and erosion, possible crystal formation in soft tissue called tophi,” Dr. Deslauriers said.

According to the 2018 recommendations for gout by the European League Against Rheumatism (EULAR), several features need to be taken into account for a diagnosis. These are: monoarticular involvement of a foot or ankle joint; previous acute episodes; rapid onset of severe pain and swelling; erythema; being male and associated #cardiovascular diseases, plus hyperuricaemia.

For a definite diagnosis, crystals need to be seen in synovial fluid or tophus aspirates.

Both the EULAR and American College of Rheumatology (ACR) guidelines state that once gout is confirmed, treatment to lower UA levels can start even while the patient is in crisis

“This is a very important point because if not done when the patient is assessed during his acute crisis, it often isn’t done at all,’’ Dr. Deslauriers said...."

The rest of the story is on the site. Sorry, password protected for people in Canadian healthcare.

#MedMastoson #rheumatology

https://www.canadianhealthcarenetwork.ca/refresher-gout-only-curable-arthritis

Gout update.
For #doctors and #pharmacists in #Canada. An overview I wrote for The Medical Post/Canadian #Healthcare Network.

"Refresher on #gout: the only curable arthritis
Often only seen in crisis, patients with gout can be cured with the right treatment and follow-up.
By Pippa Wysong

Gout is the most common inflammatory arthritis, yet it is frequently underdiagnosed, misdiagnosed and often mistreated.

Yet, according to rheumatologist Dr. Jean-Philip Deslauriers, once patients are on the right treatment, it’s the only arthritis where a cure can be achieved.

“With other arthritis conditions, the goal is remission. But with gout one can get rid of the underlying disease and attain a cure,” he said. Dr. Deslauriers is a clinical professor of #medicine at the University of Sherbrooke and spokesperson for the Arthritis Society of Canada (ASC).

“Gout is easy to treat, and most cases can be managed by family #doctors,” told the Medical Post in an interview. Gout is a painful #arthritis caused by elevated levels of serum uric acid (UA), hyperuricaemia.

Prolonged hyperuricaemia (which is generally asymptomatic and can be present for years) leads to the deposition of monosodium urate crystals in synovial fluid and other body tissues. Eventually, neutrophils will venture into the joint to try to destroy the crystals (partly unsuccessfully) but end up triggering an episode of painful inflammation—a gout crisis in which patients present with inflamed, painful and swollen joints. Often, but not always, the affected joint is in the foot or ankle, especially the first metatarsophalangeal joint.

Crystals can also be deposited in other tissue and sometimes break through the skin creating yellowish-white nodules called tophi.

There are several reasons why gout can be missed. One is that symptoms are intermittent and it can take years for crystals to build up inside joints. A patient may present to an outpatient clinic or ER where acute symptoms are treated with colchicine, #NSAIDs, cortisone infiltration or prednisone for their acute crisis, and then sent home and told to see their family physician for follow-up.
Crisis and oft missed opportunity

But a crisis, in the early stage of the disease, tends to last for only three or four days. By the time patients see an FP, they feel fine and may not mention it—if they even have access to an FP.

“Often there is only management for the crisis itself. If we don’t address the underlying cause which is too much uric acid in their blood, crises will happen again, more intensely and more frequently. And the disease will affect more joints. Over time this can lead to deformity and erosion, possible crystal formation in soft tissue called tophi,” Dr. Deslauriers said.

According to the 2018 recommendations for gout by the European League Against Rheumatism (EULAR), several features need to be taken into account for a diagnosis. These are: monoarticular involvement of a foot or ankle joint; previous acute episodes; rapid onset of severe pain and swelling; erythema; being male and associated #cardiovascular diseases, plus hyperuricaemia.

For a definite diagnosis, crystals need to be seen in synovial fluid or tophus aspirates.

Both the EULAR and American College of Rheumatology (ACR) guidelines state that once gout is confirmed, treatment to lower UA levels can start even while the patient is in crisis

“This is a very important point because if not done when the patient is assessed during his acute crisis, it often isn’t done at all,’’ Dr. Deslauriers said...."

The rest of the story is on the site. Sorry, password protected for people in Canadian healthcare.

#MedMastoson #rheumatology

https://www.canadianhealthcarenetwork.ca/refresher-gout-only-curable-arthritis

Gout update.
For #doctors and #pharmacists in #Canada. An overview I wrote for The Medical Post/Canadian #Healthcare Network.

"Refresher on #gout: the only curable arthritis
Often only seen in crisis, patients with gout can be cured with the right treatment and follow-up.
By Pippa Wysong

Gout is the most common inflammatory arthritis, yet it is frequently underdiagnosed, misdiagnosed and often mistreated.

Yet, according to rheumatologist Dr. Jean-Philip Deslauriers, once patients are on the right treatment, it’s the only arthritis where a cure can be achieved.

“With other arthritis conditions, the goal is remission. But with gout one can get rid of the underlying disease and attain a cure,” he said. Dr. Deslauriers is a clinical professor of #medicine at the University of Sherbrooke and spokesperson for the Arthritis Society of Canada (ASC).

“Gout is easy to treat, and most cases can be managed by family #doctors,” told the Medical Post in an interview. Gout is a painful #arthritis caused by elevated levels of serum uric acid (UA), hyperuricaemia.

Prolonged hyperuricaemia (which is generally asymptomatic and can be present for years) leads to the deposition of monosodium urate crystals in synovial fluid and other body tissues. Eventually, neutrophils will venture into the joint to try to destroy the crystals (partly unsuccessfully) but end up triggering an episode of painful inflammation—a gout crisis in which patients present with inflamed, painful and swollen joints. Often, but not always, the affected joint is in the foot or ankle, especially the first metatarsophalangeal joint.

Crystals can also be deposited in other tissue and sometimes break through the skin creating yellowish-white nodules called tophi.

There are several reasons why gout can be missed. One is that symptoms are intermittent and it can take years for crystals to build up inside joints. A patient may present to an outpatient clinic or ER where acute symptoms are treated with colchicine, #NSAIDs, cortisone infiltration or prednisone for their acute crisis, and then sent home and told to see their family physician for follow-up.
Crisis and oft missed opportunity

But a crisis, in the early stage of the disease, tends to last for only three or four days. By the time patients see an FP, they feel fine and may not mention it—if they even have access to an FP.

“Often there is only management for the crisis itself. If we don’t address the underlying cause which is too much uric acid in their blood, crises will happen again, more intensely and more frequently. And the disease will affect more joints. Over time this can lead to deformity and erosion, possible crystal formation in soft tissue called tophi,” Dr. Deslauriers said.

According to the 2018 recommendations for gout by the European League Against Rheumatism (EULAR), several features need to be taken into account for a diagnosis. These are: monoarticular involvement of a foot or ankle joint; previous acute episodes; rapid onset of severe pain and swelling; erythema; being male and associated #cardiovascular diseases, plus hyperuricaemia.

For a definite diagnosis, crystals need to be seen in synovial fluid or tophus aspirates.

Both the EULAR and American College of Rheumatology (ACR) guidelines state that once gout is confirmed, treatment to lower UA levels can start even while the patient is in crisis

“This is a very important point because if not done when the patient is assessed during his acute crisis, it often isn’t done at all,’’ Dr. Deslauriers said...."

The rest of the story is on the site. Sorry, password protected for people in Canadian healthcare.

#MedMastoson #rheumatology

https://www.canadianhealthcarenetwork.ca/refresher-gout-only-curable-arthritis

Pharmacists sound the alarm over ‘devastating’ condition of community amid medicine supply issues | The Independent
#Pharmacists
#Chemists
#MedicineSupply
#PharmaceuticalServicesNegotiatingCommittee
#PSNC
https://www.independent.co.uk/news/health/medicine-supply-shortages-uk-pharmacy-b2318907.html

One in three #SouthAsians with #ASCVD on statins are eligible for icosapent ethyl (IPE). IPE should be considered for this high-risk population.
Story I wrote for the #MedicalPost. (Sorry, password protected for #doctors and #pharmacists).

Highlights:
A third of South Asians in Canada with known atherosclerotic #cardiovascular disease (ASCVD) and who take #statins would qualify to get additional treatment with icosapent ethyl (IPE).

This is a significant-sized population who could benefit from the additional lowering of triglycerides using IPE, according to a study presented at the recent annual meeting of the Canadian Cardiovascular Society (#CCS). This year’s CCS had 1,400 in-person delegates, over 350 online delegates and 130 sessions.

However, a major study, the REDUCE-IT trial driving the use of IPE had very few non-white participants, according to a poster abstract presented by Canadian researchers.

IPE is a highly purified preparation of #eicosapentaenoic acid (EPA), which is an omega-3 fatty acid. It is used to treat severe hypertriglyceridemia (500 mg/dL and over). It is used as an adjunct to statin therapy to reduce the risk of cardiovascular events in people whose serum #triglyceride levels are over 150 mg/dL.
#MedMastodon

https://www.canadianhealthcarenetwork.ca/one-three-south-asians-ascvd-statins-are-eligible-icosapent-ethyl

Weeks in, it’s time for my #Introduction to #MedMastodon and #TooteRx

I’m a #CriticalCare trained and former #Trauma #Pharmacists who has transitioned to full time graduate pharmacists experiential education #PharmRes.

I support #PharmGradWishlist as the IT guy and some other things. I co-created and co-host the podcast #PreceptResponsibly. We routinely talk about topics affecting pharmacy and mentorship