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Review of content for pharmacists, students, & enthusiasts. Mainly focused on OTC and community pharmacy. Maintained by University of Cincinnati P3 @NateHerrell

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Beta blockers should not be started in patients with decompensated HF. In congested/"wet" patients ARNI/ACEI/ARB is usually better tolerated.

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Note the mAb nomenclature:
▪️xi = chimeric
▪️li = immune system

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Basiliximab is an immunosuppressant medication used as induction therapy after kidney transplant to prevent acute rejection (among other uses). One dose prior to surgery, a second dose 4 days later. Mechanism is antagonism at IL-2 receptor on T-lymphocytes by binding CD25 region.

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Tenofovir disoproxil fumarate & tenofovir alafenamide are both prodrugs of tenofovir diphosphate, but TAF is activated intracellularly & requires lower dose. It's less of a risk for kidney function and bone mineral density, but TDF may have more a more favorable effect on lipids.

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Biktarvy is a first line option for treatment naïve HIV patients. It consists of:
▪️Bictegravir, an integrase inhibitor
▪️Emtricitabine, a nucleoside reverse-transcriptase inhibitor
▪️Tenofovir alafenamide, another nucleoside reverse-transcriptase inhibitor.

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This also applies to genotype 1b!

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Treatment naïve hepatitis C genotype 1a patients have a couple of treatment options that only last 8 weeks:

1. Glecapravir/pibrentasvir (Mavyret)
2. Ledipasvir/sofosbuvir (Harvoni) if HIV negative and HCV RNA level <6 million IU/mL

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If NS5A RAS is present and Zepatier is drug of choice, duration of treatment is extended (from 12) to 16 weeks and ribavirin is added.

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Hepatitis C patients with genotype 1a should be tested for NS5A resistance-associated substitutions if Zepatier (elbasvir-grazoprevir) is being considered.

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HCV is cleared by the immune system in a minority of cases, while the rest go on to develop chronic disease. Nonetheless, only recently did AASLD/IDSA guidelines change to recommend early acute treatment. Post-exposure prophylaxis is still not recommended.

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The goal of treating hepatitis C is an undetectable level of viral RNA at 12 weeks, known as sustained virologic response (SVR). Once SVR is achieved, chances of recurrence on long-term follow up are 0-3%.

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Recall that acid alpha-glucosidase (GAA) breaks down glycogen in the lysosome. Avalglucosidase alfa-ngpt is conjugated with multiple synthetic bis-mannose-6-phosphate tetra-mannose glycans, which target the M6P receptor, which in turn transports the GAA enzyme into the lysosome.

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Nexviazyme (avalglucosidase alfa-ngpt) was recently approved for the treatment of late-onset Pompe disease, an enzyme deficiency which leads to excess glycogen buildup and muscular damage.

[Nicole Lieberman, PhD @LiebermanNicole]

I was recently asked to explain what the purpose is for each of the components of the #Pfizer and #moderna #vaccines, so here is a handy table. Hopefully it helps to demystify some of those admittedly scary sounding lipid names!

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Protein binding may be reduced in CKD due to uremia, hypoalbuminemia, and other factors. Dosing of highly protein-bound drugs may need too be adjusted accordingly.

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Saphnelo is given as a 300 mg/2 mL 30-minute intravenous infusion every 4 weeks.

Respiratory tract infections, bronchitis, infusion reactions, and hypersensitivity reactions are other potential adverse effects.

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Anifrolumab-fnia (Saphnelo) is a newly approved drug used for treatment of systemic lupus erythematosus. It works by blocking type I interferons, which are components of the inflammatory response caused by SLE.

Potential adverse effects include shingles (6.1%)!

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Methicillin is not readily broken down by beta lactamase because its dimethoxyphenyl group provides steric hindrance.

MRSA is the result of a gene called mecA which encodes altered penicillin binding proteins.

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Cefuroxime is also unique in that it is a 2nd generation cephalosporin that is able to cross the blood-brain barrier in the presence of inflammation. 1st and 2nd generation cephalosporins generally cannot.

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Cefuroxime is a 2nd generation cephalosporin whose Z-oxime group provides some steric resistance to beta-lactamase, similar to e.g. oxacillin.

Cefuroxime axetil is a prodrug that is more readily absorbed in the GI tract. The axetil group decreases the polarity of the molecule.