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Monthly Archives: March 2016

Question #824

Test Your Knowledge

Mrs. Hunter is a 36-year-old African-American who comes to your office for her annual wellness exam. She is overweight (BMI 27 kg/m2), but is otherwise healthy. She jokes that she “just can’t seem to lose that extra baby weight” after giving birth 3 years ago. However, her daughter recently started preschool, so she has been able to go to her new gym several times per week. In fact, one of the added bonuses of her membership is the free, weekly nutrition and exercise support groups. In addition to her routine labs, you order an A1C, which comes back elevated at 7.1%. This measurement is confirmed several days later. Based on Mrs. Hunter’s profile, you encourage lifestyle modifications and start metformin with an A1c target of less than 7%. You and Mrs. Hunter set a goal for A1C less than 6.5%. She returns 3 months later for a follow-up visit and her office labs show an A1C 6.8%. You congratulate her on her progress and ask her to return in another 3- 4 months. When she does, she is above her goal with an A1C 8.1%. She explains that she has gone back to full-time work and just doesn’t have the time to get to the gym anymore. At this time, what would your next step be and what would her individualized glycemic targets be? Select one answer: A. Encourage lifestyle modifications and start metformin with a target A1C less than 6.5% B. Encourage lifestyle modifications and start metformin with a target A1C less than 7.5% C. Encourage lifestyle modifications and start a 2-drug combination target A1C target less than 7% D. Encourage lifestyle modifications and and continue with metformin Follow the link to see the correct answer.

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Over the past 30 years that I have been a pharmacist, we have had many sound-alike drugs. Many of you remember when Losec became Prilosec because of the confusion with Lasix. Often we don’t even see these problems unless someone has a bad event. This week our disaster avoided looks …

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March 5, 2016

Ever since GLP-1 analogs have been available, there have been a lot of worries about cardiovascular problems. Part of this was brought on by Dr. Steven Nissen’s full frontal attack on the TZD’s (later proven to not be true). His angry commentary on the cardiovascular risks of diabetes drugs put …

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