Thiazide diuretics have been in clinical use for more than 60 years. Small studies published in the 1950s/60s reported that chlorothiazide had less diuretic and antihypertensive effect in patients with lower glomerular filtration rates which led to the belief that thiazides are ineffective in advanced CKD.  The Chlorthalidone in Chronic Kidney Disease (CLICK) Trial challenges this dogma.

Guest Authors: Michael Ernst, PharmD, BCGP and Michelle A. Fravel, PharmD, BCPS

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Traditionally, hypertension management involves a stepwise approach where agents are titrated and added. Thus, achieving optimal BP control requires close follow-up, time, and resources.  Outside of these logistics, providers are prone to clinical inertia (aka fail to advance therapy when they should) and sometimes “push back” from patients who experience the burdens of treatment and follow-up. Perhaps it’s time to reconsider our approach to managing hypertension.

Guest Authors:  Erin Connolly, PharmD and Laura Varnum, PharmD, BCACP

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Despite prevention efforts, about 1 in 3 patients diagnosed with diabetes have comorbid CKD. Half of these individuals have moderate to severe disease. Unlike patients with type 1 diabetes where it develops after many years after the diagnosis, CKD is commonly present at diagnosis in patients with type 2 diabetes. While many interventions are available to prevent the progression of CKD, more are needed.

Guest Authors: Katherine Montag Schafer, PharmD, BCACP, CDCES and Kyle Hunt, MD

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More than half of women in the United States aged 15 to 49 years use a form of contraception. However, many women discontinue use during the first 12 months. Reasons for discontinuation include inconvenience, method failure, adverse effects, and cost. But another potential factor that is not as well-studied is the sexual acceptability of the contraceptive method.

Guest Authors:  Katherine Harte, PharmD and Allison Zuern, PharmD, BCPS, CDCES

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Although guideline-directed medical therapy substantially improves morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF), treatments that clearly improve outcomes in those with HF and an EF >40% remain elusive. Unfortunately, the incidence and prevalence of HF are expected to substantially increase in the coming decades.  More evidence and effective treatments for those with HF with preserved ejection fraction are clearly needed.  Enter the EMPEROR-Preserved trial.

Guest Authors:  Gabrielle Givens, PharmD, BCPS and Robert Parker, PharmD

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Continuous glucose monitors (CGMs) are now commonplace, and every clinician should know the basics about who can benefit from CGM use and how to address common questions and problems. 

Authors:  Brianna Patacini, PharmD, BCACP, CDCES and Dawn Fuke, PharmD, BCPS

Special Guest: Jennifer Trujillo, PharmD, BCPS, CDCES, BC-ADM

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Every day, millions suffer from poor sleep that disrupts their lives, and long-term sleep disorders can cause attention deficits, mood disorders, anxiety, and depression. Several prescription treatment options for sleep are available but they often have undesirable side effects and can lead to tolerance and dependency. Thus, a natural product that has been documented to improve sleep with minimal adverse events may be a better choice.

Guest Authors:  Alyssa Korman, PharmD and Nicole Slater, PharmD, BCACP

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There are now over 30 unique therapeutic entities (and countless different products!) to treat hyperglycemia in patients with type 2 diabetes mellitus (T2DM).  While the glucagon-like peptide-1 (GLP-1) receptor agonists improve glycemic control, renal, and cardiovascular outcomes and induce significant weight loss, drugs that target more than one incretin hormone may have even greater therapeutic benefits.

Guest Authors: Nadila Faridi, PharmD and Kathleen Pincus, PharmD, BCPS, BCACP

Special Guest: Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES

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WARNING: Patient has a penicillin allergy! Do you want to continue with this cephalexin order?

Although these warnings are commonplace, immunologic cross-reactivity between penicillins and cephalosporins is uncommon. When B-lactams are indicated as first-line therapy for therapy, cephalosporins are often avoided if the patient has a penicillin allergy listed. Would the removal of EHR warnings about potential penicillin allergies when cephalosporins are ordered be helpful or harmful? 

Guest Authors:  Brian Wenger, PharmD and Nora Sharaya, PharmD, BCPS, BCACP, BC-ADM

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There is no consensus regarding the preferred dosage of aspirin in patients with atherosclerotic cardiovascular disease (ASCVD) and this has led to variability in prescribing patterns. This is likely due to the lack of head-to-head trials evaluating different aspirin doses and data weighing the clinical benefits and adverse effects experienced with aspirin. Until now?

Guest Authors: Ivy Nwogu, PharmD and Megan Supple, PharmD, BCACP, CPP

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