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Pharmacology

Is Your Patient Taking Calcium Channel Blockers?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Calcium Channel Blockers Indications Angina Arrhythmias Hypertension Migraine prophylaxis: Verapamil Muscle cramps: Diltiazem  Product Summary Pharmacology This monograph focuses on the calcium channel blockers (CCBs) affecting the cardiovascular system. CCBs (also referred to as slow channel blockers, calcium entry blockers or calcium antagonists) are a chemically and pharmacologically heterogeneous group of drugs, but physiologically they all share the ability to selectively antagonize the calcium ion movements that are responsible for the excitation-contraction coupling in the cardiovascular system. There are two main classes of CCBs: Dihydropyridines (amlodipine, felodipine, nifedipine and ...

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What is the current state of second- and third-line therapy for patients with type 2 diabetes?

This summary is based on comprehensive Optimal Therapy Reports on the topic prepared by Canadian Agency for Drugs and Technologies in Health (CADTH): Second- and Third-Line Therapy for Patients with Type 2 Diabetes Report Summary (PDF) Full Report (PDF) The Canadian Agency for Drugs and Technologies in Health (CADTH) has released a series of Optimal Therapy Reports on the prescribing and use of second-line therapy for patients with type 2 diabetes inadequately controlled on metformin, and a therapeutic review of third-line therapy for patients with type 2 diabetes inadequately controlled with metformin and a sulfonylurea combination therapy. CADTH has also released intervention tools to support the uptake ...

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Is your patient on benzodiazepines?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Benzodiazepines Benzodiazepines Product Summary Information   Indications   Contraindications Patients with known hypersensitivity to this class of drugs or to any component of the product in question. Patients with myasthenia gravis and acute angle-closure glaucoma, but they may be used in patients receiving appropriate therapy for open-angle glaucoma. Warnings Not recommended for use in patients with a major depressive disorder or psychosis in which anxiety is not a prominent feature. Should be used with extreme caution in patients with severe pulmonary insufficiency or sleep apnea, especially the elderly ...

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Is your patient undergoing treatment with biphosphonates?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Biphosphonates Product Summary Pharmacology Bisphosphonates (previously called diphosphonates) are stable analogues of pyrophosphate. After binding to bone surfaces, they slow the formation of hydroxyapatite crystals and delay their aggregation into large clusters. They also interfere with the resorptive action and promote apoptosis (programmed cell death) of osteoclasts, resulting in decreased depth and rate of formation of new bone remodeling units. Lifelong accumulation of remodeling deficits begins shortly after bone growth stops and is thought to be the underlying mechanism of age-related bone loss. By inhibiting this process, bisphosphonates ...

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Is your patient on barbiturates?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Barbiturates Barbiturates Product Summary Information   Barbiturates are nonselective central nervous system (CNS) depressants, capable of producing all degrees of depression from mild sedation and hypnosis to general anesthesia, deep coma and death. The extent of CNS depression varies with the route of administration, dose and pharmacokinetic characteristics of the particular barbiturate. Patient-specific factors such as age, physical or emotional state and the concomitant use of other drugs will also affect response. Indications Barbiturates have been used parenterally in the management of status epilepticus or acute seizure episodes ...

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Is your patient is on ACE Inhibitors?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: ACE Inhibitors ACE Inhibitors Product Summary Information Drug Administration Dosage Form Strength Benazepril Oral Tablet 5 mg, 10 mg, 20 mg Captopril Oral  Tablet 6.25 mg, 12.5 mg, 25 mg, 50 mg, 100 mg Cilazapril Oral  Tablet 1 mg, 2.5 mg, 5 mg Enalapril Maleate Oral  Tablet 2.5 mg, 5 mg, 10 mg, 20 mg Enalaprilat IV Solution 1.25 mg/mL Fosinopril Oral Tablet 10 mg, 20 mg Lisinopril Oral Tablet 5 mg, 10 mg, 20 mg Perindopril Oral Tablet 2 mg, 4 mg, 8 mg Quinapril Oral Tablet ...

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How safe are benzodiazepines?

This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: High dose and watchful dosing of benzodiazepines: a review of the safety and guidelines Full Report (PDF)   Key Findings No “watchful dose” for benzodiazepines was identified. Benzodiazepines may be used in higher than 10 mg diazepam-equivalent doses in some circumstances, but data were limited. Context   Benzodiazepines are compounds that enhance the activity of gamma-aminobutyric acid (GABA)-A receptors by increasing the affinity of the receptors for GABA. Therefore, benzodiazepines are prescribed as anxiolytic medications. In Canada, the labeled indications include, the treatment of anxiety disorders, panic disorder, ...

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How and When Is Epinephrine Used As A Vasoconstrictor in Local Anesthetics?

This Prescription Drug Consult is presented by the JCDA Oasis Team and is also available through JCDA Oasis Mobile Epinephrine in LA (Adrenalin®) Presentation Epinephrine is a an alpha-/beta-agonist that is administered as an adjuvant in local anesthetic cartridges. Epinephrine is also used as an emergency drug for treatment of anaphylactic reaction and a vasoconstrictor to decrease systemic absorption of local anesthetics and to increase the duration of anesthetic action. The use of Epinephrine may decrease superficial hemorrhage. Dosage May be used in concentrations of 1:500,000 to 1:50,000. 1:100,000 and 1:200,000 is used most commonly in a typical 1.8 ml local anesthetic dental ...

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