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Westberg SM, Arellano R, Cieri-Hutcherson NE, Heinrich NT, Herman AM, Lodise NM, McBane S, Ofili TU, O'Grady N, Sankey KH. Pharmacotherapy of Chronic Neuropsychiatric Conditions During Pregnancy. Nurs Womens Health 2024:S1751-4851(24)00082-5. [PMID: 38702041 DOI: 10.1016/j.nwh.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/08/2023] [Accepted: 03/28/2024] [Indexed: 05/06/2024]
Abstract
Many pregnant persons will experience neuropsychiatric conditions during pregnancy, including migraine, attention deficit disorder, depression, and anxiety. Treatment of each of these conditions requires shared decision-making among the individual, family, and health care team. Although medications may include risk, the benefits often outweigh the potential fetal risks. In this article, we review pharmacologic treatment options for each of these conditions and appropriate use in pregnancy to maintain the stability of conditions and to optimize maternal and fetal outcomes.
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Abstract
Complications throughout the peripartum period may be caused by preexisting conditions or pregnancy-induced conditions and may alter pharmacotherapy management. Pharmacotherapy management during late pregnancy and delivery requires careful consideration due to changing hormones, hemodynamic status, and pharmacokinetics, and concerns for potential maternal and/or fetal morbidity. Increased maternal and fetal monitoring are often required and may lead to therapy changes. Pharmacists, as key members of the interprofessional team, can contribute essential perspective to the management of postpartum pharmacotherapy through assessment and recommendation of appropriate and judicious use of medications.
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Affiliation(s)
- Kylie N Barnes
- Kansas City School of Pharmacy, University of Missouri, Kansas City, MO, USA
| | - Lauren D Leader
- Obstetrics and Gynecology, Von Voigtlander Women's Hospital, Michigan Medicine, Ann Arbor, MI, USA
| | - Nicole E Cieri-Hutcherson
- Pharmacy Practice, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA
| | | | - Mary F Hebert
- Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Lamis R Karaoui
- Department of Pharmacy Practice, Lebanese American University School of Pharmacy, Byblos, Lebanon
| | - Sarah McBane
- School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, USA
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Cieri-Hutcherson NE, Marji EK, Hutcherson TC. Systematic review of neurokinin-3 receptor antagonists for the management of vasomotor symptoms of menopause. Menopause 2024; 31:342-354. [PMID: 38471077 DOI: 10.1097/gme.0000000000002328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
IMPORTANCE Vasomotor symptoms (VMS) affect many postmenopausal persons and impact sleep and quality of life. OBJECTIVE This systematic review examines the literature describing the safety and efficacy of neurokinin-3 receptor antagonists approved and in development for postmenopausal persons with VMS. EVIDENCE REVIEW A search of MEDLINE, EMBASE, and International Pharmaceutical Abstracts was conducted using the search terms and permutations of neurokinin-3 receptor antagonist, elinzanetant, fezolinetant, and osanetant. Inclusion criteria of reporting on efficacy or safety of fezolinetant, elinzanetant, or osanetant; studies in participants identifying as female; full record in English; and primary literature were applied. Abstract-only records were excluded. Extracted data were synthesized to allow comparison of reported study characteristics, efficacy outcomes, and safety events. Eligible records were evaluated for risk of bias via the Cochrane Risk of Bias 2 tool for randomized studies and the Grading of Recommendations Assessment, Development and Evaluation system was used. This study was neither funded nor registered. FINDINGS The search returned 191 records; 186 were screened after deduplication. Inclusion criteria were met by six randomized controlled trials (RCT), four reported on fezolinetant, and two reported on elinzanetant. One record was a post hoc analysis of a fezolinetant RCT. An additional study was identified outside the database search. Three fezolinetant RCT demonstrated a reduction in VMS frequency/severity, improvement in Menopause-Specific Quality of Life scores, and improvement in sleep quality at weeks 4 and 12 compared with placebo without serious adverse events. The two RCT on elinzanetant also showed improvements in VMS frequency and severity. All eight records evaluated safety through treatment-emergent adverse events; the most common adverse events were COVID-19, headache, somnolence, and gastrointestinal. Each record evaluated had a low risk of bias. There is a strong certainty of evidence as per the Grading of Recommendations Assessment, Development and Evaluation system. CONCLUSIONS AND RELEVANCE Because of the high-quality evidence supporting the efficacy of fezolinetant and elinzanetant, these agents may be an effective option with mild adverse events for women seeking nonhormone treatment of VMS.
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Vernon VP, Cieri-Hutcherson NE, Arellano R, Collins O, Lodise NM. Contraception for transgender and gender diverse individuals in pharmacy education: A cross-sectional survey and select resources. Curr Pharm Teach Learn 2023; 15:715-721. [PMID: 37487786 DOI: 10.1016/j.cptl.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/20/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Pharmacists must be knowledgeable to care for all patients, including transgender and gender diverse individuals. Some institutions may have gaps in their pharmacy school curriculum specific to transgender contraceptive care. The current study evaluated and offered recommendations regarding the current state of transgender contraceptive care education within pharmacy curricula. METHODS An 18-question anonymous survey was developed and sent to members of the American Association of Colleges of Pharmacy - Pharmacy Practice section contact list. The survey collected baseline demographic characteristics and curricular information, including whether contraception for transgender individuals was taught and the modalities utilized. The institutional review board at Butler University reviewed and approved this survey project. RESULTS A response rate of 68% was obtained (99 of 144 institutions). Of those institutions responding, 39% reported that contraception for transgender individuals is taught as part of the curriculum at their respective institutions. In addition, a diverse set of teaching modalities were reported, such as didactic and team-based learning. Only six (4.3%) of the 138 individual faculty respondents indicated they obtained training focused on transgender care. CONCLUSIONS Approximately 40% of the responding institutions reported teaching about contraception care for transgender individuals. Based on this survey, the authors encourage institutions to assess their current curriculum and incorporate this topic accordingly. In addition, the authors recommend offering development opportunities for faculty and student pharmacists so that current and future health care professionals are best equipped to provide care for all patients in any practice.
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Affiliation(s)
- Veronica P Vernon
- Pharmacy Practice, Butler University College of Pharmacy and Health Sciences, 4600 Sunset Ave, Pharmacy and Health Sciences Building, Indianapolis, IN 46208, United States.
| | - Nicole E Cieri-Hutcherson
- University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY 14214, United States.
| | - Regina Arellano
- Midwestern University College of Pharmacy Downers Grove Campus, Downers Grove, IL 60515, United States.
| | | | - Nicole M Lodise
- Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, NY 12208, United States.
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Wares KE, Cieri-Hutcherson NE, Woodruff AE, Hutcherson TC. Community pharmacist recommendations regarding raspberry leaf for induction of labor: A mystery caller approach. J Am Pharm Assoc (2003) 2023; 63:1168-1174. [PMID: 37084809 DOI: 10.1016/j.japh.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/05/2023] [Accepted: 04/13/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Raspberry leaf products are recommended by health care providers to induce labor despite insufficient efficacy and safety data. Less is known about community pharmacists' knowledge and recommendations regarding raspberry leaf products. OBJECTIVE The primary end point was to describe New York State community pharmacist recommendations regarding raspberry leaf for labor induction. Secondary end points evaluated pharmacists' assessment of the patient for additional information, citation of a supporting reference, provision of safety and efficacy information, recommendation of a patient-appropriate reference, and change in recommendation after learning about the obstetrician-gynecologist's recommendation. DESIGN Using a list of registered New York State pharmacies via a Freedom of Information Law request, a randomized representative sample of included pharmacy types (grocery store, drugstore chain, independent, and mass merchandising) was called using a mystery caller approach. Calls were conducted by one investigator throughout July 2022. Data collection included items specific to the primary and secondary outcomes. This study was approved by the associated institutional review board. SETTING AND PARTICIPANTS New York State community pharmacists from grocery store, drugstore chain, independent, and mass merchandising pharmacies were called using the mystery caller approach. OUTCOME MEASURES The primary endpoint was measured by the number of evidence-based recommendations made by pharmacists. RESULTS The study included 366 pharmacies. Despite insufficient efficacy and safety data, there were 308 recommendations to use raspberry leaf products (n = 308 of 366, 84.1%). Most pharmacists attempted to collect additional patient information (n = 278 of 366, 76.0%). Many pharmacists did not clearly convey safety (n = 168 of 366, 45.9%) or efficacy (n = 197 of 366, 53.8%) information. Of those who discussed safety or efficacy, many said raspberry leaf products were safe and effective (n = 125 of 198, 63.1%; n = 82 of 169, 48.5%). Pharmacists often referred or deferred the patient to another medical professional for more information (n = 92 of 282, 32.6%). CONCLUSION There is an opportunity to improve pharmacists' knowledge on the use of raspberry leaf products for the induction of labor and in making evidence-based recommendations when limited or conflicting efficacy and safety data exist.
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Bartelme KM, Cieri-Hutcherson NE, Anderson L, Barnes KN, Karaoui LR, Meredith AH. Survey of colleges and schools of pharmacy to determine restrictions for teaching, research, and advocacy related to contraception. Curr Pharm Teach Learn 2023:S1877-1297(23)00139-9. [PMID: 37355387 DOI: 10.1016/j.cptl.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 05/05/2023] [Accepted: 06/14/2023] [Indexed: 06/26/2023]
Abstract
INTRODUCTION The pharmacist's role in reproductive health is evolving. Since 46 states allow providers to refuse to provide reproductive health services, it is important to consider whether learning is impacted by institution restrictions on contraception teaching, advocacy, and research. METHODS An electronic survey was emailed to deans of all pharmacy schools on the American Association of Colleges of Pharmacy Institutional Membership list with a request to share with faculty teaching women's health content within their curriculum. The survey collected information about contraception teaching, research, and advocacy. RESULTS Of 145 schools contacted, 39 (27%) provided complete responses. Of these, 22 (56%) were public, not religiously-affiliated, 7 (18%) were private, not religiously-affiliated, six (15%) were private, currently religiously-affiliated, and 4 were (10%) private, historically religiously-affiliated. All respondents taught hormonal contraception in the required curriculum and 15 (39%) taught miscarriage management/abortifacients. None reported restrictions on contraception teaching or research. One respondent cited an advocacy restriction for contraception methods due to violation of the school's beliefs, and another cited an advocacy restriction for miscarriage management/abortifacients. Respondents noted students expressed ethical questions/concerns about refusing to dispense contraception (59%), dispensing certain contraceptives (54%), dispensing to minors (46%), and dispensing all contraceptives (21%). Additionally, respondents reported pharmacists/faculty expressed ethical questions/concerns about refusing to dispense contraception (31%), dispensing to minors (21%), dispensing certain contraceptives (15%), and all contraceptives (13%). CONCLUSIONS Overall, respondents reported no restrictions in contraception teaching and scholarship and minimal advocacy restrictions. Faculty should consider ethical questions/concerns from students, faculty, and pharmacists when teaching this material.
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Affiliation(s)
- Kassandra M Bartelme
- Department of Pharmacy Practice, Concordia University Wisconsin School of Pharmacy, 12800 North Lake Shore Road, Mequon, WI 53097, United States.
| | - Nicole E Cieri-Hutcherson
- Department of Pharmacy Practice, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, 217 Pharmacy Building, Buffalo, NY 14214, United States.
| | - Lorinda Anderson
- Oregon State University College of Pharmacy, 1601 SW Jefferson Street, Corvallis, OR 97331, United States.
| | - Kylie N Barnes
- Division of Pharmacy Practice and Administration, University of Missouri - Kansas City School of Pharmacy, 2464 Charlotte Street, Kansas City, MO 64108, United States.
| | - Lamis R Karaoui
- Assistant Dean for Student Affairs, Director of Experiential Education, Lebanese American University School of Pharmacy, P.O. Box 36 S 23, Byblos, Lebanon.
| | - Ashley H Meredith
- Department of Pharmacy Practice, Purdue University, 575 Stadium Mall Drive, West Lafayette, IN 47907, United States.
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Vernon V, Patel J, Cieri-Hutcherson NE, Arellano R, Elmore H, Griffin BL, Mitzel K, Moyeno WM, O'Connell MB, Pelaccio K, Lodise NM. The impact of COVID-19 on select considerations in patients of reproductive age: Brief talking points for pharmacists. J Am Pharm Assoc (2003) 2023; 63:720-724. [PMID: 36775738 PMCID: PMC9831663 DOI: 10.1016/j.japh.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has elicited many health concerns, including the impact of the infection and vaccine on reproductive health. Although robust evidence demonstrates the safety of all available COVID-19 vaccines, misinformation and disinformation related to the vaccine continue to circulate. As accessible and essential health care workers, it is crucial that pharmacists are informed of the evidence related to effects of the COVID-19 infection and vaccinations on reproductive health care. Menstrual cycle changes have been noted owing to COVID-19 infection, pandemic stress, and COVID-19 vaccination. COVID-19 infection and vaccination have not been shown to influence female fertility, pregnancy rates, and lactation. The use of exogenous estrogen may further contribute to an increased risk of thromboembolism with COVID-19 infection, and differences in the risk of cerebral venous sinus thrombosis appear to exist between the types of vaccines. The benefits of COVID-19 vaccination outweigh any risks. Shared decision-making is necessary when discussing vaccination with patients. Pharmacists play a vital role in dispelling misinformation and disinformation related to the impact of COVID-19 illness and vaccination on reproductive health care.
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Hutcherson TC, Cieri-Hutcherson NE, Lycouras MM, Koehler D, Mortimer M, Schaefer CJ, Costa OS, Bohlmann AL, Singhal MK. Systematic Review of Evening Primrose ( Oenothera biennis) Preparations for the Facilitation of Parturition. Pharmacy (Basel) 2022; 10:pharmacy10060172. [PMID: 36548328 PMCID: PMC9787658 DOI: 10.3390/pharmacy10060172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The objective of this systematic review was to characterize the efficacy and safety of evening primrose (EP) for facilitation of parturition in peripartum persons. METHODS This search sought records related to the efficacy and safety of EP preparations to facilitate parturition. Eligibility criteria were primary literature with efficacy or safety outcomes reported; studied in peripartum persons; and available in English. Records were excluded if they were available as abstracts only. Data was synthesized by study characteristics, patient demographics, and outcomes. The RoB2 and ROBINS-I were used to assess risk of bias. RESULTS A total of 11 studies met inclusion criteria: seven randomized placebo-controlled trials, one randomized non placebo-controlled trial, one case study, one observational retrospective study, and one quasi-experimental cross-sectional study. Efficacy outcomes included Bishop scores and duration of labor during the different phases. Reported adverse events were generally mild and included increased blood pressure, decreased heart rate, pain, bleeding, nausea, and vomiting. Important risks of bias exist across the literature reviewed. CONCLUSIONS The use of EP for parturition in peripartum individuals is not recommended. Further research is warranted before use during parturition or the peripartum period. Other: The authors deny conflicts of interest. The study was neither registered nor funded.
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Affiliation(s)
- Timothy C. Hutcherson
- Department of Pharmacy Practice, School of Pharmacy, D’Youville University, Buffalo, NY 14201, USA
| | - Nicole E. Cieri-Hutcherson
- Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Correspondence: ; Tel.: +1-(716)-870-7213
| | - Maggie M. Lycouras
- Department of Pharmacy, Mount Saint Mary’s Hospital, Lewiston, NY 14092, USA
| | - Dharmista Koehler
- Department of Pharmacy Practice, School of Pharmacy, D’Youville University, Buffalo, NY 14201, USA
| | - Madison Mortimer
- Department of Pharmacy Practice, School of Pharmacy, D’Youville University, Buffalo, NY 14201, USA
| | - Christina J. Schaefer
- Department of Pharmacy Practice, School of Pharmacy, D’Youville University, Buffalo, NY 14201, USA
| | - Olivia S. Costa
- The Janssen Pharmaceuticals Companies of Johnson & Johnson, Albany, NY 19044, USA
| | - Ashley L. Bohlmann
- Department of Pharmacy, Rochester General Hospital, Rochester, NY 14621, USA
| | - Mudit K. Singhal
- Department of Pharmaceutical, Social and Administrative Sciences, School of Pharmacy, D’Youville University, Buffalo, NY 14201, USA
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Cieri-Hutcherson NE, Lomakina A, Chilbert MR. Retrospective Study of Appropriate Primary Prevention in Postmenopausal Women Presenting with a Major Adverse Cardiovascular Endpoint (MACE). Pharmacy 2022; 10:pharmacy10050105. [PMID: 36136838 PMCID: PMC9498536 DOI: 10.3390/pharmacy10050105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Postmenopausal women may be at an increased risk for cardiovascular events. The postmenopausal transition represents a key time for implementation of preventative strategies to reduce the risk of cardiovascular disease. The objective of this study was to evaluate the appropriate use of primary prophylaxis of cardiovascular disease in this population and to determine if an opportunity exists for improvement in primary prevention prescribing. Methods: A single-center, retrospective study was conducted of postmenopausal women aged 45–60 years between 1 October 2019 and 30 April 2021 with a diagnosis of a new major adverse cardiovascular event (MACE). This study was approved by the University at Buffalo Institutional Review Board. Results: After application of inclusion and exclusion criteria, 231 patients were included and analyzed. Median age was 55 years; 66.6% white; median body mass index was 30.11 kg/m2; 30.3% history of diabetes; 51.1% current smokers; 82.3% with a primary care provider (PCP); 97.6% insured. Patients with diabetes, current smokers, and those without a PCP were more likely to have inappropriate primary prevention use than patients without diabetes, non-smokers, and with a PCP, respectively (78.7% vs. 51.3%, p = 0.0002; 57.6% vs. 42.4%, p = 0.0177; 73.7% vs. 56.0%, p = 0.0474). Specifically, current smokers, and those with diabetes had significantly more inappropriate use of aspirin and statins for primary prevention than non-smokers and patients without diabetes. Conclusions: This study observed the use of appropriate primary prevention therapies in postmenopausal women and found that an opportunity may exist to improve prescribing appropriate primary prevention therapies for certain groups, most notably in postmenopausal women with diabetes, smokers, uninsured, and those without a PCP.
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Stone RH, Cieri-Hutcherson NE, Vernon V, Arellano R, Mospan C, Harris JB, Barnes KN, Griffin BL, Lodise NM, Patel J, Rafie S, Vest K. Curricular Considerations for Preparing Student Pharmacists to Prescribe Hormonal Contraception. Am J Pharm Educ 2022; 86:8667. [PMID: 34385172 PMCID: PMC10159422 DOI: 10.5688/ajpe8667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/02/2021] [Indexed: 05/06/2023]
Abstract
In 2014, the pharmacist's role in the United States expanded to include prescribing hormonal contraception, and this practice is currently addressed by policy in 14 states and the District of Columbia. Training and education requirements for this expanded scope of practice vary between states and are changing rapidly. The objective of this review is to examine how student pharmacists are taught to provide contraceptive care, specifically for prescribing ongoing hormonal contraception and emergency contraception, and to identify potential gaps in the United States pharmacy curricula related to contraception. Despite steady adoption into community pharmacy practice, there is sparse literature assessing educational methods used to teach contraceptive care. This review offers recommendations to promote consistent and comprehensive student pharmacist education in providing contraceptive care across institutions, regardless of state policy status.
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Affiliation(s)
| | | | - Veronica Vernon
- Butler University, College of Pharmacy and Health Sciences, Indianapolis, Indiana
| | - Regina Arellano
- Midwestern University, College of Pharmacy - Downers Grove, Downers Grove, Illinois
| | - Cortney Mospan
- Wingate University, School of Pharmacy, Wingate, North Carolina
| | | | - Kylie N Barnes
- University of Missouri - Kansas City, School of Pharmacy, Kansas City, Missouri
| | - Brooke L Griffin
- Midwestern University, College of Pharmacy - Downers Grove, Downers Grove, Illinois
| | - Nicole M Lodise
- Albany College of Pharmacy and Health Sciences, Albany, New York
| | - Jaini Patel
- Midwestern University, College of Pharmacy - Downers Grove, Downers Grove, Illinois
| | - Sally Rafie
- University of California San Diego Health, San Diego, California
| | - Kathleen Vest
- Midwestern University, College of Pharmacy - Downers Grove, Downers Grove, Illinois
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Fan CW, Cieri-Hutcherson NE, Hutcherson TC. Systematic Review of Black Cohosh ( Cimicifuga racemosa) for Management of Polycystic Ovary Syndrome-Related Infertility. J Pharm Pract 2021; 35:991-999. [PMID: 33926292 DOI: 10.1177/08971900211012244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a common cause of female infertility. To conduct a systematic review assessing the efficacy and safety of black cohosh for ovulation-induction through hormone regulation and increased endometrial thickness to improve pregnancy rates in women with PCOS-related infertility. Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used. A search of Medline, Embase, International Pharmaceutical Abstracts, Science Direct, and Cumulative Index of Nursing and Allied Health Literature spanning origin to December 19, 2020 was conducted using keywords and permutations of "black cohosh" and "PCOS." A search for "PCOS" in the National Clinical Trials database and International Clinical Trials Registry Platform was conducted in December 2020 to identify additional records. Eligibility criteria included reported efficacy or safety outcomes; studies in women with PCOS; English language; and primary literature. Eligible records were evaluated using applicable risk-of-bias tools. A total of 181 records were screened after deduplication from 207 results. Two randomized controlled trials (RCT) met inclusion criteria. Review of 1386 records from clinical trial registries and subsequent scoping searches resulted in identification of 4 additional records (3 published). Improvement in hormone regulation and endometrial thickness were found for black cohosh groups compared to clomiphene citrate (CC). Three RCTs reported improved pregnancy rates using black cohosh plus CC. There were no differences in adverse events. Studies demonstrated several risk-of-bias concerns. There is a lack of high-quality evidence supporting the effectiveness of black cohosh for improving pregnancy rates in PCOS-related infertility. Short-term use of black cohosh appears to be safe.
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Affiliation(s)
- Chi Wai Fan
- 15497University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA
| | - Nicole E Cieri-Hutcherson
- Department of Pharmacy Practice, 15497University at Buffalo School of Pharmacy and Pharmaceutical Science, Buffalo, NY, USA
| | - Timothy C Hutcherson
- Department of Pharmacy Practice, Drug Information Center, D'Youville School of Pharmacy, Buffalo, NY, USA
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Cieri-Hutcherson NE, Jaenecke A, Bahia A, Lucas D, Oluloro A, Stimmel L, Hutcherson TC. Systematic Review of l-Arginine for the Treatment of Hypoactive Sexual Desire Disorder and Related Conditions in Women. Pharmacy (Basel) 2021; 9:pharmacy9020071. [PMID: 33801678 PMCID: PMC8103282 DOI: 10.3390/pharmacy9020071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 01/11/2023] Open
Abstract
This systematic review evaluates the efficacy and safety of l-arginine alone or in combination for the treatment of women with hypoactive sexual desire disorder (HSDD) or related conditions, such as female sexual interest/arousal disorder and female sexual arousal disorder. Medline, Embase, International Pharmaceutical Abstracts, Science Direct, and the Cumulative Index to Nursing and Allied Health Literature were searched using keywords “arginine”, “Lady Prelox”, “ArginMax”, “Stronvivo”, “Ristela”, “hypoactive sexual desire disorder”, “female sexual interest arousal disorder”, “female sexual arousal disorder”, “sexual dysfunction”, “sexual behavior”, “dyspareunia”, “libido”, and permutations thereof. Relevant records were retained if they were primary literature, conducted in women with HSDD or related conditions, and published as full text in English. Five randomized controlled trials and two nonrandomized studies met eligibility criteria. Six of the seven studies reported either an increase in the total mean Female Sexual Function Index score or significant increases in multiple domains therein. One study assessed vaginal pulse amplitude and found a statistically significant increase in a combination treatment group compared to placebo. No significant side effects were reported. Four of seven studies had potential risk-of-bias concerns per Cochrane assessments. This systematic review found that combination products containing l-arginine in the form of ArginMax or Lady Prelox may be considered for the treatment of HSDD and related conditions in women regardless of age.
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Affiliation(s)
- Nicole E. Cieri-Hutcherson
- Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Correspondence: ; Tel.: +1-716-645-3635
| | - Andrea Jaenecke
- School of Pharmacy, D’Youville College, Buffalo, NY 14201, USA; (A.J.); (A.B.); (L.S.)
| | - Ajeet Bahia
- School of Pharmacy, D’Youville College, Buffalo, NY 14201, USA; (A.J.); (A.B.); (L.S.)
| | - Debra Lucas
- Montante Family Library, D’Youville College, Buffalo, NY 14201, USA;
| | - Ann Oluloro
- Department of Obstetrics and Gynecology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA;
| | - Lora Stimmel
- School of Pharmacy, D’Youville College, Buffalo, NY 14201, USA; (A.J.); (A.B.); (L.S.)
| | - Timothy C. Hutcherson
- Department of Pharmacy Practice, School of Pharmacy, D’Youville College, Buffalo, NY 14201, USA;
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Abstract
PURPOSE Postpartum depression (PPD) is defined as a major depressive episode occurring during pregnancy or within 4 weeks of delivery that may have significant consequences for mother and infant. Antidepressants are used to treat PPD, but their effectiveness may be limited by a slow time to peak effect. Brexanolone is Food and Drug Administration-approved for the management of PPD; its use requires patient participation in a risk evaluation and mitigation strategies (REMS) program. This review evaluates the efficacy and safety of brexanolone in PPD. SUMMARY Four completed studies, 1 quasi-experimental study and 3 randomized controlled trials (RCTs), were reviewed. Females who had moderate or severe PPD during the third trimester or within 4 weeks of delivery and were less than 6 months postpartum at initiation of therapy were included. Improvement in Hamilton Rating Scale for Depression (HAM-D) scores was assessed in addition to safety outcomes and scores on other depression rating scales. All studies demonstrated statistical improvement in HAM-D scores from baseline with brexanolone vs placebo use at the end of infusions (ie, hour 60). Results with regard to sustained HAM-D score improvements were mixed in the RCTs at 30-day follow-up. The most frequent adverse events in brexanolone-treated patients were sedation, dizziness, somnolence, and headache. The severe or serious adverse effect of presyncope, syncope, or loss of consciousness was reported by 4% of participants. CONCLUSION With a rapid onset of action, brexanolone could be considered advantageous over traditional therapies for PPD in patients for whom a rapid response is required due to severity of disease. Significant concerns remain regarding sustained effect and use in patients outside of the clinical trial setting.
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Cieri-Hutcherson NE, Hutcherson TC, Conway-Habes EE, Burns BN, White NA. Systematic Review of l-glutamine for Prevention of Vaso-occlusive Pain Crisis in Patients with Sickle Cell Disease. Pharmacotherapy 2019; 39:1095-1104. [PMID: 31505045 DOI: 10.1002/phar.2329] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
l-glutamine was approved by the U.S. Food and Drug Administration (FDA) for sickle cell disease (SCD) in 2017. A vaso-occlusive crisis (VOC) occurs in persons with SCD and is associated with acute pain episodes. This systematic review summarizes the evidence for l-glutamine in the prevention of VOC and associated pain in patients with SCD. Medline, Embase, and International Pharmaceutical Abstracts were searched for records reporting on l-glutamine use in persons with SCD. Eligibility criteria identified primary reports of investigations conducted in humans who were administered l-glutamine, reported on outcomes related to VOC or associated pain, published in English, and were available as full text. All relevant efficacy, safety, participant demographic data, and study method characteristics were extracted and documented. Risk-of-bias assessments were conducted using the Risk of Bias in Non-Randomized Studies-of Interventions (ROBINS-I) tool and the revised Cochrane risk-of-bias tool for randomized studies. Three studies assessing the effect of exogenous l-glutamine administration in patients with SCD met eligibility criteria: one prospective nonrandomized controlled study and two prospective randomized controlled trials. Rate of VOC and related hospitalizations were reduced in patients receiving l-glutamine, although some conflicting results were noted between studies. l-glutamine was generally well tolerated. Limitations of one or more of the eligible studies included small sample size, nonblinding, and study groups that differed at baseline. l-glutamine has limited high-quality evidence supporting its use. Although l-glutamine is FDA approved for the prevention of frequent episodes of VOC pain, only one randomized controlled trial has strong evidence to support this indication. Based on the results of a systematic review, l-glutamine may be considered for patients unable to receive hydroxyurea or in addition to hydroxyurea for reduction in VOC and associated pain.
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Affiliation(s)
- Nicole E Cieri-Hutcherson
- Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Science, University at Buffalo, Buffalo, New York
| | - Timothy C Hutcherson
- Department of Pharmacy Practice, D'Youville College School of Pharmacy, Drug Information Center, Buffalo, New York
| | - Erin E Conway-Habes
- Department of Medicine, Jacobs School of Medicine & Biomedical Sciences, Buffalo, New York
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Hutcherson TC, Cieri-Hutcherson NE, Donnelly PJ, Feneziani ML, Grisanti KMR. Evaluation of Mobile Applications Intended to Aid in Conception Using a Systematic Review Framework. Ann Pharmacother 2019; 54:178-186. [PMID: 31510755 DOI: 10.1177/1060028019876890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: This review identified and evaluated apps intended to aid women in conception that were available across major mobile platforms; secondary objectives were to highlight additional criteria and considerations when evaluating conception-related apps. Data Sources: Apple iTunes and Google Play stores were searched using the keywords conception, fertility, and pregnant. Data Selection: Included apps were as follows: contained in the first 50 search results; presented in English; intended for layperson use; updated July 1, 2018, or after; marketed as a conception aid; and used a defined fertility tracking method. Excluded apps were intended for men only, marketed for contraception only, promoted a single fertility service or branded product, or not found in both app stores. Data Extraction: Apps were evaluated using the adapted APPLICATIONS Scoring System. Two additional criteria were assessed: inclusion of a privacy policy and inclusion of a search function, medical terminology glossary, or Frequently Asked Questions section. Data Synthesis: A total of 300 apps were screened; 7 app pairs were analyzed. Scores ranged from 9 to 13 of a possible 15 points (mean = 11; median = 11). No app reported advisement from a health professional during development. Relevance to Patient Care in Clinical Practice: Widely available apps that score highly per the adapted APPLICATIONS Scoring System may be considered for use by and recommended to women seeking apps useful for conception. Conclusion: Evaluation tools should evolve as app features change. Criteria related to privacy and search functions that promote health literacy should be considered for future app evaluation tools.
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Rafie S, Cieri-Hutcherson NE, Frame TR, Griffin B, Harris JB, Horlen C, Shealy K, Stein AB, Stone RH, Vest K, Westberg S, Yancey AM. Pharmacists’ Perspectives on Prescribing and Expanding Access to Hormonal Contraception in Pharmacies in the United States. J Pharm Pract 2019; 34:230-238. [DOI: 10.1177/0897190019867601] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Pharmacist prescribing of contraception is becoming increasingly available in selected states. The objective of this study was to assess US community pharmacists’ perspectives on expanding access, barriers, and facilitators since states have begun pharmacist scope of practice expansions for prescribing contraception. Methods: A survey study of US community pharmacists’ support for expanded access models, pharmacist prescribing practices and interest, and importance of safety, cost, and professional practice issues for prescribing was conducted. Results: Pharmacists are generally supportive of pharmacist prescribing and behind-the-counter models for hormonal contraception and generally opposed to over-the-counter access. A majority (65%) are interested in prescribing hormonal contraception. The top motivation for prescribing contraception is enjoying individual patient contact (94%). Safety concerns (eg, patients not obtaining health screenings) remained most important for pharmacist implementation, followed by cost (eg, lack of payment or reimbursement for pharmacists’ services), and professional practice (eg, pharmacist time constraints and liability) issues. Conclusion: This study provides an updated understanding of attitudes toward models of expanded access to hormonal contraception, interest in prescribing, and barriers and facilitators to this service among community pharmacists. Many barriers such as time and reimbursement remain unchanged. This information can inform policy and implementation efforts.
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Affiliation(s)
- Sally Rafie
- Department of Pharmacy, UC San Diego Health, San Diego, CA, USA
| | - Nicole E. Cieri-Hutcherson
- Department of Pharmacy Practice, University at Buffalo School of Pharmacy and Pharmaceutical Science, Buffalo, NY, USA
| | - Tracy R. Frame
- Pharmacy Practice Department, Belmont University College of Pharmacy, Nashville, TN, USA
| | - Brooke Griffin
- Chicago College of Pharmacy, Midwestern University, Mt Sinai Medical Group, Downers Grove, IL, USA
| | - John Brock Harris
- Department of Pediatrics & Neonatology, Wingate University School of Pharmacy, Novant Health Hemby Children’s Hospital, Wingate, NC, USA
| | - Cheryl Horlen
- University of the Incarnate Word, Feik School of Pharmacy, San Antonio, TX, USA
| | - Kayce Shealy
- Presbyterian College School of Pharmacy, Clinton, SC, USA
| | - Amy Buros Stein
- Office of Research and Sponsored Programs, Midwestern University, Glendale, AZ, USA
| | - Rebecca H. Stone
- Department of Clinical and Administrative Pharmacy, Mercy Health Center, University of Georgia College of Pharmacy, Athens, GA, USA
| | - Kathleen Vest
- Chicago College of Pharmacy, Midwestern University, Downers Grove, IL, USA
| | - Sarah Westberg
- College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | - Abigail M. Yancey
- St Louis College of Pharmacy, SSM Health St. Mary’s Clinical Pharmacy Specialist, St. Louis, MO, USA
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Hutcherson TC, Cieri-Hutcherson NE, Bhatt R. Evidence for Idarucizumab (Praxbind) in the Reversal Of the Direct Thrombin Inhibitor Dabigatran: Review Following the RE-VERSE AD Full Cohort Analysis. P T 2017; 42:692-698. [PMID: 29089725 PMCID: PMC5642158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Idarucizumab is the first reversal agent approved for the direct thrombin inhibitor dabigatran. The authors summarize the findings from the clinical trial series and describe case reports, post-marketing data, and ongoing studies.
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