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16 Nov

Regular Marijuana Use Linked to Increased Heart Failure Risk

Recent observational research presented at the American Heart Association (AHA) 2023 Scientific Sessions reveals a 34% higher risk of heart failure within four years associated with daily marijuana use compared to non-use. The findings, while observational and indicating association rather than causation, contribute to a growing body of evidence on the potential cardiovascular effects of marijuana.

The study, led by Yakubu Bene-Alhasan, MD, MPH, and colleagues, examined data from the National Institutes of Health–sponsored All of Us research program. The analysis included 156,999 adults aged 18 or older without a baseline heart failure diagnosis. During a median follow-up of 45.3 months, 2958 incidents of heart failure events occurred. After adjusting for various factors, daily marijuana users exhibited a 34% increased heart failure risk, though this significance diminished when factoring in coronary artery disease (CAD).

Bene-Alhasan emphasized that the study cannot establish causation but noted a growing body of evidence suggesting negative cardiovascular effects associated with marijuana use. The study categorized participants based on reported marijuana use frequency, revealing that daily users faced an increased risk compared to never-users.

Another study presented at the same sessions by Avilash Mondal, MD, and colleagues explored the association between cannabis use disorder (CUD) and major adverse cardiac and cerebral events (MACCEs) in older patients with cardiovascular risk factors who were tobacco nonsmokers. The study, based on National Inpatient Sample data, found that patients with CUD had a 20% increased risk for MACCEs, including all-cause mortality, acute myocardial infarction, cardiac arrest, or stroke.

The research sheds light on the potential cardiovascular risks associated with marijuana use, emphasizing the need for healthcare providers to inquire about patients’ cannabis use when obtaining medical histories. Both studies highlight the complexity of assessing the impact of marijuana on cardiovascular health and underscore the importance of continued research in this evolving field.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your health care provider first. Full Disclaimer https://centrumpharmacy.com/disclaimer/

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10 Nov

A History of Military Service by Pharmacists

This Remembrance Day, We at Centrum Pharmacy would also like to inform you of the roles and services that Pharmacists in the military have played and continue to play in safeguarding our troops and ultimately our freedom.

History of Pharmacists in the Military:

This history lesson highlights the indispensable role pharmacists have played in various wars, from World War II to modern conflicts.

World War II: The Unsung Heroes: Pharmacists faced dangers of combat, with individuals like Robert Knecht and Paul Stanley Frament losing their lives. Despite the risks, wounded soldiers expressed gratitude for the vital role played by medics, including pharmacists.

Early Challenges: 1930s-1940s: Pharmacy education required a baccalaureate degree, but this didn’t grant a military commission. The value of pharmacists wasn’t always aligned with their rank and pay. Ultimately, a dispensing error in 1930 highlighted the need for employing skilled pharmacists in the military.

Recognition and Struggle: In 1943, President Roosevelt established the Pharmacy Corps in the Army. Approximately 14,000 pharmacists or students served during WWII. Post-war, the Pharmacy Corps was replaced by the Medical Service Corps in 1947.

Korean War: Advancements and Opportunities: The Korean War saw advancements in pharmacy and pharmaceuticals. Pharmacists contributed to formulary development, and pharmacy officers played a crucial role in intravenous fluid therapy.

Postgraduate Training and Recognition: In the late 1950s and early 1960s, pharmacy officers competed for postgraduate training. In 1958, the first master’s degree program in hospital pharmacy was completed. In 1966, the Secretary of Defense mandated that major military medical treatment facilities must be staffed with licensed pharmacists.

Vietnam War: Controversy and Improvement: The Vietnam War sparked controversy, but military medical services improved in specialization and speed. Pharmacists played crucial roles in medical evacuation systems, highly trained medical specialties, and biomedical research.

Modern Era: Clinical Pharmacy and Combat Deployment: In the 1980s, clinical pharmacy took shape, and the Pharm.D. degree became recognized for promotion. The 1990s saw the establishment of clinical pharmacy practices. Operations Desert Shield, Desert Storm, Somalia, Haiti, and Bosnia provided pharmacists with opportunities in combat deployments.

Present Day: Homeland Security and Unified Forces: All branches of military medicine work jointly for homeland security. Pharmacists are responsible for pharmacy operations, personnel, and entire ambulatory healthcare facilities. They play a significant role in medication logistics, inventory activities, and homeland defense readiness.

Conclusion: Military pharmacists, in wartime and peacetime, continue to play a crucial role in protecting the country. Their sacrifices deserve honor and respect, in all its aspects.

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10 Nov

The Role of Pharmacists in the Military

This Remembrance Day, We at Centrum Pharmacy, would also like to inform you of the crucial roles and services that pharmacists in the military play in safeguarding our troops and ultimately our freedom.

Deployed pharmacists find themselves with distinct challenges, assuming the role of primary drug experts in unconventional and sometimes hostile environments. Their responsibilities go beyond the usual screening, packaging, and distribution of medications.

The Deployed Pharmacist’s Role:

Expertise and Availability:

1. - Deployed pharmacists serve as the go-to experts for managing, storing, and obtaining pharmaceuticals.
  - Often the sole pharmacist in their operational area, they are expected to be available at all times.

Diverse Positions:

- Deployed pharmacists may hold various positions such as field hospital pharmacist, division pharmacist, medical logistics pharmacist, and theater pharmacy consultant.
- Proficiency in both outpatient and inpatient pharmacy, coupled with logistics expertise, is crucial.

Challenges Faced:

Logistics and Supply Management:

1. - Significant challenges include logistics and supply management.
  - Concerns such as supply availability, controlled substance accountability, and management of refrigerated items arise.

Formulary Changes and Varying Missions:

- Adapting to formulary changes, varying missions, and addressing manpower challenges are common issues.
- The unpredictable nature of deployments necessitates flexibility and quick decision-making.

Pharmacists’ Experiences:

Preparation:

1. - Emphasis on mental preparation, with a focus on sterile compounding and critical care.
  - On-the-job training becomes crucial, especially in understanding the logistics side of pharmacy and medicine.

Unique Medications:

1. - Deployed pharmacists may encounter medications not typically found in traditional pharmacies, depending on the environment.
  - Examples include snake antivenom in Afghanistan, emphasizing the need for adaptability.

Handling Unique Situations:

- Being prepared for situations like mass casualties, enemy fire, disrupted logistics channels, and evacuations is crucial.
- Ensuring units have enough medications during critical moments is a top priority.

This year, we would like to highlight the contributions of one such Pharmacist Hero:

Shelley Hempstead. Please follow the link below to read about her story:

https://www.bcpharmacy.ca/news/military-officer-community-pharmacist

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10 Nov

Cardiovascular Disease Research in Women: Underrepresented and Underdiagnosed

Cardiovascular disease (CVD) stands as the primary global cause of death, accounting for approximately 17.9 million fatalities in 2019. In Canada, it ranks as the second leading cause of death for both men and women, with heart disease and stroke emerging as the top culprits for premature female mortality. Notably, the manifestation of heart disease differs between genders; women commonly exhibit microvascular disease in smaller vessels, while men tend to experience macrovascular disease in larger vessels. Consequently, the symptoms presented by women may vary from those observed in men. Hormone-related changes, specific medical conditions, and medications unique to women can also influence CVD development. Unfortunately, research studies have not consistently included women, resulting in unequal representation and potentially disparate treatments upon diagnosis. Addressing this gap requires further studies and enhanced educational efforts tailored to women, recognizing their distinct experiences with CVD, characterized by smaller vessel involvement and specific risk factors. Here is a breakdown:

Differences in Presentation:

Acute Coronary Syndrome (ACS):
- Women present at an older age than men.
- Atypical symptoms such as fatigue, shortness of breath, and palpitations are more common.
- Higher risk of heart failure and cardiogenic shock post-STEMI.
- Less likely to receive reperfusion therapy or attend cardiac rehabilitation.
Heart Failure (HF):
- Hypertension and diabetes pose higher risks for women.
- HF with preserved ejection fraction (HFpEF) is more common.
- Underrepresented in HF trials; may benefit more from certain medications.
- Less likely to receive device therapy (ICD or CRT) compared to men.
Atrial Fibrillation (AF):
- Greater risk of AF-related stroke than men.
- Higher morbidity and mortality associated with AF.
- Less likely to receive catheter ablation or optimal anticoagulation.
Hypertension:
- Prevalence increases after menopause.
- Undertreatment of hypertension in women suggested.
Dyslipidemia:
- Elevated cholesterol increases MI risk.
- Statin use may be lower in women post-MI.
Diabetes:
- Higher risk of coronary heart disease and adverse outcomes post-STEMI.
- Underdiagnosed and undertreated in women.
Stroke:
- Higher lifetime risk in women.
- Delayed diagnosis and suboptimal treatment for women.

Conditions and Risk Factors More Prevalent in Women:

Spontaneous Coronary Artery Dissection (SCAD):
- Mainly affects women, especially during pregnancy.
- High risk of recurrent CV events.
Takotsubo Syndrome:
- Affects women more often, linked to emotional or physical stress.
Polycystic Ovarian Syndrome (PCOS):
- Increases the risk of metabolic syndrome.
Pregnancy/Menarche:
- Adverse pregnancy outcomes increase CVD risk.
- Menopause, especially premature, elevates CVD risk.
Influence of Medications:
- Estrogen–progestin contraceptives increase thrombosis risk.
- Hormone replacement therapy impact is inconclusive.
Autoimmune and Inflammatory Diseases:
- Women with autoimmune diseases face increased CVD risk.

Improving awareness and care for CVD in women is crucial, and pharmacists can play a pivotal role in this endeavour. Pharmacists possess the expertise to educate patients, enhancing their understanding of cardiovascular disease (CVD) risk factors, as well as the signs and symptoms of the condition, especially in women. Their role extends to educating on non-drug interventions, encompassing aspects like increased physical activity, maintaining a healthy diet, ensuring adequate sleep, stress reduction, and avoiding smoking—all of which contribute to lowering CVD risk. In the management of CVD risk factors such as diabetes and hypertension, pharmacists play a crucial role in assisting patients in achieving optimal blood glucose/A1C and blood pressure targets. Beyond that, they contribute significantly to the management of heart failure (HF), reducing HF hospitalizations when part of a multidisciplinary HF team. Numerous studies highlight the positive impact of pharmacist involvement in areas like diabetes, hypertension, smoking cessation, adherence in coronary heart disease (CHD) and HF, and cardiovascular mortality in HF.

Please speak to your pharmacist at Centrum Pharmacy to gain a better understanding of women’s heart disease and how your lifestyle and medications play a role in your health.

By Centrum Pharmacy Medical Info Comments Off

09 Nov

Tai Chi and its Effects on the Brain, particularly for the Elderly

I have long advocated tai chi as a form of exercise, especially for the elderly and for individuals with physical challenges that make conventional aerobic exercises difficult to perform. If you’ve never done tai chi, which is a martial art that incorporates a series of movements, known as forms, with a focus on controlled breathing. It may look like nothing much is happening, but that’s a misconception. In fact, you are actually working very hard, and the physical benefits are pronounced. Many studies have shown that practicing tai chi can also help prevent falls and improve balance in older adults, and the benefit is greatest for people who keep up a regular practice over time.

There has always been a suggestion that Tai Chi also has a beneficial effect on the brain and for maintaining mental acuity. Finally, there is a controlled study that seems to back up those claims:

Tai chi is not just a physical exercise; it’s a mental workout too! A recent study shows that practicing tai chi can significantly slow cognitive decline and protect against dementia, especially for older adults.

The study involved approximately 300 older adults, with an average age in their mid-70s, who reported experiencing a decline in their memory. All participants took a cognitive function test called the Montreal Cognitive Assessment, where a normal score ranges from 26-30. The average score at the beginning of the study was 25, indicating mild impairment.

The findings revealed that those who practiced a simplified form of tai chi called Tai Ji Quan twice a week for six months improved their cognitive test scores by 1.5 points. While it may seem like a modest increase, study author Dr. Elizabeth Eckstrom emphasizes that it’s akin to giving oneself three extra years of staving off cognitive decline.

For those engaged in a more rigorous type of tai chi, known as Cognitively Enhanced Tai Ji Quan, which involves additional challenges like spelling words backward and forward during tai chi moves, the improvement was about 3 points. This translates to giving individuals an extra six years of cognitive function.

The study suggests that the memorization of tai chi movements, combined with fluid mind-body coordination, contributes to its effectiveness in preserving cognitive function. This combination of physical activity and memory engagement appears to be a winning formula.

Dr. Joseph Quinn, a neurologist not involved in the study, finds the results impressive, even though he admits not fully understanding why tai chi works so well. He speculates that the meditative component and stress reduction effect could be contributing factors.

Participants in the study expressed the meditative nature of tai chi, describing it as a practice that helps them feel grounded, release stress, and improve concentration. Beyond the cognitive benefits, tai chi has long been recognized for its impact on balance and fall prevention in older adults.

While the study predominantly involved non-Hispanic white participants with college degrees, researchers acknowledge the need for efforts to make tai chi more accessible to a broader population, especially considering the disproportionate burden of cognitive impairment among certain demographic groups.

In essence, tai chi isn’t just a series of graceful movements—it’s a dance for the mind and body, providing not only physical benefits but also a powerful defense against cognitive decline.

By Centrum Pharmacy Healthy Lifestyle Comments Off

09 Nov

Obesity and Breast Cancer Recurrence

Obesity has been found to elevate the risk of breast cancer recurrence in postmenopausal patients with hormone receptor–positive (HR+) early-stage breast cancer who are undergoing treatment with aromatase inhibitors, according to a comprehensive study conducted over an 18-year period using data from the Danish Breast Cancer Group.

Clinical studies have consistently highlighted obesity as a risk factor for recurrence in postmenopausal women with HR+ breast cancer. Notably, evidence suggests that women with obesity may not experience the same protective effects from aromatase inhibitors as those with a healthy weight, although limited data exist on this subject.

The cohort study, involving postmenopausal women diagnosed with stage I to III HR+ breast cancer receiving adjuvant endocrine therapy with aromatase inhibitors, categorized patients based on their body mass index (BMI). The BMI categories included healthy weight (18.5–24.9), overweight (25–29.9), obesity (30–34.9), and severe obesity (≥ 35), with patients of a healthy weight serving as the reference group for statistical analyses.

Key findings from the study include:

Patient Enrollment and Follow-Up:
- A total of 13,230 patients with BMI information participated, with a median age at diagnosis of 64.4 years.
- Throughout a median follow-up of 6.2 years, 1,587 recurrences were observed.
Recurrence Hazards:
- Multivariable analyses revealed increased recurrence hazards associated with obesity (adjusted HR, 1.18 [95% CI, 1.01–1.37]) and severe obesity (adjusted HR, 1.32 [95% CI, 1.08–1.62]) compared to patients with a healthy weight.
- Patients with overweight also exhibited a greater risk of recurrence, but the results did not reach statistical significance (adjusted HR, 1.10 [95% CI, 0.97–1.24]).

The study’s conclusion underscores the link between obesity and an elevated risk of breast cancer recurrence in postmenopausal patients with HR+ early-stage breast cancer undergoing aromatase inhibitor therapy. This large, population-based cohort study aligns with prior research, indicating that patients with obesity may derive less benefit from adjuvant endocrine therapy than those with a healthy weight.

The authors advocate for further exploration into whether alternative endocrine therapies, such as tamoxifen, should be considered for postmenopausal women with obesity and early-stage HR+ breast cancer to enhance their prognosis, challenging the current recommendation of aromatase inhibitors for this patient population. However, one thing is certain, weight loss is clearly indicated for postmenopausal women with obesity and early-stage HR+ breast cancer to enhance their prognosis and enhance their general health.

By Centrum Pharmacy Healthy Lifestyle Comments Off

09 Nov

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By Centrum Pharmacy Pharmacy Updates Comments Off

Regular Marijuana Use Linked to Increased Heart Failure Risk

Cardiovascular Disease Research in Women: Underrepresented and Underdiagnosed

Tai Chi and its Effects on the Brain, particularly for the Elderly

Obesity and Breast Cancer Recurrence

IS YOUR PHARMACY CLOSING? HAS YOUR PHARMACY JUST CLOSED?

Come try Centrum Pharmacy (centrumpharmacy.com)

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