Afleveringen
-
To open the episode, Erica Marini, PharmD, discussed a roundup of FDA and research updates in neurology. She covered the shifting accelerated-approval pathway for AMT-130 (uniQure), a gene therapy for Huntington disease, and a similar back-and-forth for a Hunter syndrome gene therapy. She also noted an expanded indication for olezarsen (Tryngolza; Ionis Pharmaceuticals) in severe hypertriglyceridemia, a UK study linking hypotension to Alzheimer risk, and data suggesting shingles vaccination may lower dementia risk in Medicare beneficiaries.
From the American Headache Society meeting, she highlighted phase 2b data on the TRPM8 agonist elismotrep (Kallyope), and the anti-PACAP antibody bocunebart (Lundbeck) for migraine, along with retrospective findings tying CGRP monoclonal antibodies to increased fracture risk and higher odds of spontaneous abortion in early pregnancy.
The core interview featured Adrian Wong, PharmD, MPH, BCCCP; and Cayley Krkljes, PharmD, BCPS, of Beth Israel Deaconess Medical Center who discussed a systematic review published in Pharmacotherapy of clinically significant drug-drug interactions with phenobarbital and primidone. Wong and Krkljes described growing use of phenobarbital for alcohol withdrawal and note that health care professionals often underappreciate its interaction potential despite it being a well-known enzyme inducer. Key findings included an induction onset of 24 hours to 30 days and an offset of 2 to 8 weeks, findings that carry particular weight for transitions of care since inpatient dosing effects can persist well after discharge. The most clinically impactful interactions involved anticoagulants (warfarin and direct oral anticoagulants [DOACs]), methadone, and immunosuppressants, with approximately 85% of reviewed studies reporting some outcome impact. They also pushed back on recent social media claims that phenobarbital-DOAC interactions are not clinically relevant, pointing out methodological limitations in the studies behind that claim.
The conversation moved into practical risk stratification: The guests described considering a patient's individual risk factors—such as recent thrombosis, transplant status, or opioid use disorder treatment with methadone or buprenorphine—before choosing phenobarbital over benzodiazepines for alcohol withdrawal.
They outlined next steps for research, including studying real-world outcomes in high-risk medication combinations and surveying health care professional awareness of these interactions to identify education gaps. The episode closed with career advice for pharmacists interested in research—start small, find mentors, and leverage institutional resources.Key Takeaways:
Phenobarbital's interaction risk is widely underrecognized. Despite growing use for alcohol withdrawal, phenobarbital's enzyme-inducing effects can persist for weeks after the last dose (onset 24 hours to 30 days; offset 2 to 8 weeks), making transitions of care a critical window for catching interactions—especially with anticoagulants, methadone, and immunosuppressants, which accounted for the most clinically impactful outcomes in the review.Not all "reassuring" data holds up under scrutiny. Wong and Krkljes challenged circulating social media claims that phenobarbital-DOAC interactions aren't clinically relevant, noting the studies behind those claims had methodological limitations, emphasizing the importance of evaluating primary literature rather than secondhand interpretations.Risk stratification should guide phenobarbital use. Individual patient factors (eg, recent thrombosis, transplant status, or opioid use disorder treatment with methadone or buprenorphine) should inform whether phenobarbital or a benzodiazepine is the safer choice for alcohol withdrawal management. -
Zijn er afleveringen die ontbreken?
-
Find out more information about the Psychedelic Pharmacists Foundation (PPF) & Psychedelic Pharmacists Association (PPA):
PPF: https://www.psychedelicpharmacistsfoundation.org/
PPA: https://psychedelicpharmacist.org/ -
The discussion examines the evidence behind common concerns about everyday products, food trends, and lifestyle habits, while emphasizing a practical, individualized approach to health and cancer prevention.
-
A panel of clinical pharmacists meets to discuss the complex process of operationalizing cell and gene therapy at an academic medical center.
-
In this episode of Mind the Meds, Erica Marini, PharmD, highlights information from the European Stroke Organization Conference include encouraging data on asundexian
(Bayer), a factor XIa inhibitor showing reduced recurrent ischemic stroke risk without increased bleeding, as well as positive results from three trials of tirofiban in acute ischemic stroke settings. On the multiple sclerosis (MS) front, Marini covers the FDA approval of ocrelizumab (Ocrevus; Genentech) for pediatric relapsing-remitting MS in children 10 and older, a new study supporting early use of high-efficacy agents in pediatric MS, and 2 Lancet publications on ocrelizumab — one examining higher weight-adjusted dosing (which did not improve disability progression) and one confirming benefit in a broader primary progressive MS population. She also briefly discusses PADOVA (NCT04777331), a phase 2b trial of prasinezumab in early Parkinson's disease, which failed to meet its primary end point.
The bulk of the episode is a discussion with guest Millad Sobhanian, PharmD, BCPS, clinical pharmacy specialist in neurology at the University of Maryland, focused on Alzheimer disease. They cover dextromethorphan/bupropion (Auvelity; Axsome Therapeutics), newly approved in April 2026 for agitation associated with Alzheimer dementia. Sobhanian walks through key safety considerations—including additive NMDA antagonism if combined with memantine, cardiovascular risks from the bupropion component, and the ever-present black box warning on antipsychotics in dementia patients—while both note that the efficacy data, though statistically significant, shows modest clinical effect sizes compared to the threshold for meaningful within-patient change.
The conversation then turns to lecanemab's subcutaneous initiation formulation (Leqembi Iqlik; Eisai, Biogen), whose FDA decision has been delayed to about August 2026 as regulators seek more data on bioavailability and ARIA monitoring in the at-home setting. Sobhanian shares his real-world perspective on anti-amyloid therapy, describing a patient population that is typically early-stage, high-functioning, and has a mean age of about 60 to 70 years, and emphasizing the pharmacist's role in expectation-setting around the modest but potentially cumulative slowing of cognitive decline.
The episode closes with a thorough discussion of the April 2026 Cochrane review on amyloid-targeting monoclonal antibodies, which both Marini and Sobhanian find overly broad in its conclusions. They note limitations such as the inclusion of withdrawn agents like aducanumab (Aduhelm; Biogen), heterogeneous inclusion criteria across trials, and an 18-month study horizon that may be too short to capture the full benefit suggested by longer-term open-label extension data.Key Takeaways:
1. New options for Alzheimer's agitation exist, but fit carefully into the treatment algorithm. Dextromethorphan/bupropion offers a novel NMDA-based mechanism for treating agitation in Alzheimer dementia, but its clinical effect size is modest, and it carries meaningful safety considerations—particularly around the bupropion component in elderly patients. Like all pharmacologic options in this space, it remains a later-line choice after nonpharmacologic interventions have been exhausted, and medication reconciliation is critical given its interaction potential with memantine and CYP2D6 inhibitors.
2. Anti-amyloid therapies are imperfect but not ready to be written off. The April 2026 Cochrane review drew significant attention with its conclusion that anti-amyloid monoclonal antibodies produce only trivial cognitive benefits, but its findings are limited by the inclusion of older, withdrawn agents, heterogeneous trial populations, and an 18-month time horizon that may be too short to capture the full trajectory of benefit.
3. The pharmacist's role in anti-amyloid therapy goes well beyond dispensing. As illustrated by Sobhanian's practice at the University of Maryland, clinical pharmacists embedded in neurology clinics play a critical role in patient selection, expectation-setting, ARIA counseling, and informed decision-making for patients considering anti-amyloid therapy—a complex, high-stakes treatment decision that these patients and their caregivers should never be navigating alone. -
In this episode of Pharmacy Focus, moderator Bob Haight, PharmD, BCPP, AAPP Annual Meeting director and past president of American Association of Psychiatric Pharmacists (AAPP), discusses the AAPP 2026 Annual Meeting with Archana Jhawar, PharmD, BCPP, clinical assistant professor at the University of Illinois Chicago; and Chelsea Di Polito, PharmD, BCPP, psychiatric clinical pharmacist at the University of Maryland, Baltimore. The discussion centers on emerging trends in psychiatric pharmacotherapy across diverse practice settings. A major focus is on newer psychiatric medications, including sublingual dexmedetomidine for acute agitation, which offers a novel, patient-friendly administration route and potential benefits for inpatient care. Additional discussion covers agents like lumateperone and xanomeline-trospium, with attention to their safety profiles, tolerability, and evolving roles in treatment. The speakers emphasize the importance of real-world experience in determining how these newer therapies fit into clinical decision-making, especially given considerations like cost, monitoring requirements, and patient-specific factors.
The episode also explores cutting-edge research and practice challenges, including the growing interest in GLP-1 receptor agonists for substance use disorders. While still considered “unproven but promising,” early data suggest these agents may reduce addictive behaviors by modulating reward pathways rather than through traditional metabolic effects. Additional highlights include evolving strategies for clozapine monitoring following REMS changes, where pharmacists play a central role in balancing safety and access, and advancements in long-acting injectable antipsychotics that improve flexibility, adherence, and patient-centered care. Across all topics, a consistent theme emerges: the expanding range of treatment options requires clinicians to stay informed, adaptable, and focused on individualized care. The speakers conclude that AAPP’s annual meeting provides a valuable forum for translating emerging evidence into practical strategies that can be immediately applied in clinical practice.Read more about the AAPP here: https://aapp.org/ed/meeting/2026
New psychiatric treatments are expanding options but require real-world context. Emerging therapies—such as sublingual dexmedetomidine, lumateperone, and xanomeline-trospium—offer novel mechanisms, improved tolerability, and alternative administration routes. However, clinicians are still determining where these agents fit in practice, making shared clinical experience and practical insights critical for informed use.Innovative research is reshaping how clinicians think about psychiatric and substance use treatment. GLP-1 receptor agonists are gaining attention for substance use disorders, with early evidence suggesting they may reduce addictive behaviors by acting on reward pathways. While still investigational, this highlights a broader shift toward targeting underlying neurobiology rather than just symptoms.Pharmacists play a central role in navigating evolving care models and improving patient outcomes. From optimizing clozapine monitoring after REMS changes to implementing long-acting injectable antipsychotics, pharmacists are key in balancing safety, access, adherence, and education. Their involvement is essential as treatment options become more complex and patient-centered.
Additional information on the AAPP Annual meeting can be found here: https://aapp.org/
Key Takeaways: -
You can connect with Marilyn Bulloch on LinkedIn here.
Read more insights about hepatitis B throughout Hepatitis Awareness Month at Pharmacy Times' Hepatitis Resource Center.
Episode Timestamps:
1:05: Introduction
2:08: Current Disease Burden of Hepatitis B
3:55: Risk Landscape for Adults
7:20: Link Between Chronic Hepatitis B and Liver Cancer
10:25: Expanded Vaccine Recommendations
13:25: The Role of Pharmacists in Vaccine Counseling
16:40: Why Shorter Conversations Are Better
17:55: Advantages of 2-Dose Schedule
20:40: Closing the Adult Hepatitis B Immunization Gap
23:50: A Patient Counseling Scenario
25:25: Closing Thoughts -
When a cancer patient says "I've been doing some research," the conversation that follows can be just as complex as the treatment itself. In this episode, a malignant hematology clinical pharmacy specialist joins us to unpack health misinformation, AI-generated medical advice, wellness culture, and the controversial therapies oncology patients are bringing into the clinic — and how pharmacists can navigate it all.
-
This inaugural episode of Mind the Meds introduces neurology pharmacy practice through a discussion between 3 neurology pharmacists working across inpatient and outpatient settings at the University of Utah. Host Erica Marini, PharmD, meets with her colleagues, Sarah Dahoney, PharmD, and Tyler Kenny, PharmD, BCCCP, both of whom are clinical pharmacists at the University of Utah Health, to discuss the research presented at the 2026 American Academy of Neurology (AAN) Annual Meeting. After sharing their diverse professional “origin stories,” the conversation then shifts to the role of pharmacists in neurology care and highlights key updates from the American Academy of Neurology annual meeting.
The hosts discuss advances in neuromuscular disease, particularly myasthenia gravis, where emerging therapies such as FcRn inhibitors and CAR T-cell therapies are reshaping treatment paradigms. They also explore rare neurological conditions like stiff person syndrome and Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), where early-phase trials suggest promising but still preliminary therapeutic options.
Finally, the episode reviews broader neurologic and systemic trends, including GLP-1 receptor agonists and SGLT2 inhibitors, noting potential but not yet definitive benefits in dementia prevention, stroke risk reduction, and migraine outcomes. Across all topics, the episode emphasizes the rapid evolution of neurological therapeutics and the expanding role of pharmacists in maneuvering complex, high-cost, and highly specialized treatments.Key Takeaways:
Neurology pharmacy is highly collaborative and evolving, with non-linear career pathways. Pharmacists in neurology often enter the field through diverse experiences rather than a standardized training pipeline, and success depends heavily on adaptability, clinical curiosity, and initiative. Pharmacists play a critical role in optimizing complex neurological therapies and care transitions. Their contributions span inpatient safety monitoring, outpatient medication access and affordability support, and ensuring continuity of care for high-risk, high-cost therapies. Neurology therapeutics are rapidly advancing, but many emerging treatments remain early-stage. New therapies such as FcRn inhibitors, CAR T-cell approaches, and complement-targeting agents show promise across conditions like myasthenia gravis and rare neuroimmunologic diseases, while broader drug classes like GLP-1s are still under investigation for neurological benefits. -
Dr. JAM can be found on LinkedIn.
Stay tuned for Pharmacy Times' coverage of APhA 2026 in LA. It can all be found here.
-
You can find more information about Derek Webb, PharmD, and Dennis Williams, PharmD, BCPS, AEC, below:
Derek Webb on LinkedIn
This content was independently developed by Pharmacy Times. While we acknowledge the support of our sponsor, all editorial decisions and opinions remain solely those of Pharmacy Times. Any reference to brands is for informational purposes only and not an endorsement.
Dennis Williams on LinkedIn
Dennis Williams Faculty Page - UNC Eshelman School of Pharmacy -
You can find more information about Derek Webb, PharmD, and Dennis Williams, PharmD, BCPS, AEC, below:
Derek Webb on LinkedIn
This content was independently developed by Pharmacy Times. While we acknowledge the support of our sponsor, all editorial decisions and opinions remain solely those of Pharmacy Times. Any reference to brands is for informational purposes only and not an endorsement.
Dennis Williams on LinkedIn
Dennis Williams Faculty Page - UNC Eshelman School of Pharmacy -
On Chen, MD, and Tahmid Rahman, MD discuss how plozasiran—an RNA-based APOC3-targeting therapy for patients with familial chylomicronemia syndrome with infrequent injections and a favorable safety profile—can transform care when integrated through coordinated multidisciplinary workflows with pharmacists leading patient identification, access, and monitoring.
- Laat meer zien
