4- Thursday Pharmacotherapy News – 11th November

1 – Mechanisms and Potential Roles of Glucose-Lowering Agents in COVID-19: A Review

• This study aims to explore mechanistic benefits of glucose-lowering agents that extend beyond glycemic control with the potential to mitigate coronavirus disease 2019 (COVID-19) complications.
• This review summarizes the current knowledge of glucose-lowering agents and their potential roles in COVID-19 outcomes.
• Certain glucose-lowering agents may offer additional benefits beyond glucose control—namely, by modulating the mechanisms contributing to adverse outcomes related to COVID-19 in patients with diabetes.
• DPP-IV inhibitors and metformin appear to have the most promise.
• However, current published literature on diabetes medications and COVID-19 should be interpreted with caution. Most published studies are retrospective and consist of convenience samples, and some lack adequate analytical approaches with confounding biases.
• Ongoing trials aim to evaluate the effects of glucose-lowering agents in reducing the severity of COVID-19 outcomes.

Source: SAGE Journals

2 – Resources Assessment for Penicillin Allergy Testing Performed by Pharmacists at the Patient’s Bedside

• False penicillin allergies lead to increased antimicrobial resistance, adverse effects, and health care costs by promoting the use of broad-spectrum antibiotics.
• The Infectious Diseases Society of America recommends the implementation of allergy testing.
• The primary objective of this research was to estimate the number of pharmacist full-time equivalents (FTEs) required for an intervention aimed at determining penicillin allergy in hospitalized patients.
• Acceptance of pharmacists’ suggestions on antibiotic therapy are described.
• This study describes penicillin allergy testing and the number of median weekly hospital pharmacist FTEs required, which was approximately 0.15. These data may aid in the implementation of this safe intervention that promotes narrower-spectrum antibiotherapy.

Source: SAGE Journals

3 – Use of Pediatric Injectable Medicines Guidelines and Associated Medication Administration Errors: A Human Reliability Analysis

• In a recent human reliability analysis (HRA) of simulated pediatric resuscitations, ineffective retrieval of preparation and administration instructions from online injectable medicines guidelines was a key factor contributing to medication administration errors (MAEs).
• The aim of the present study was to use a specific HRA to understand where intravenous medicines guidelines are vulnerable to misinterpretation, focusing on deviations from expected practice (discrepancies) that contributed to large-magnitude and/or clinically significant MAEs.
• Discrepancies during the use of an online injectable medicines guideline were often associated with subsequent MAEs, including those with potentially significant consequences.
• This highlights the need to test the usability of guidelines before clinical use.

Source: SAGE Journals

4- Evaluation of Dipeptidyl Peptidase-IV Inhibitor Use in Hospitalized Patients With Diabetes

• Glycemic control within goal blood glucose (BG) ranges is essential to minimize hospital complications for patients with type 2 diabetes mellitus (T2DM).
• Optimal treatment in the non–intensive care unit (ICU) setting includes a basal insulin containing regimen.
• Dipeptidyl peptidase-IV (DPP-IV) inhibitors have minimal hypoglycemia incidence and may be an appropriate bolus insulin replacement in the inpatient setting.
• This study aims to determine the effect of basal insulin plus DPP-IV inhibitor compared with basal plus bolus insulin in hospitalized patients with T2DM.
• A significant difference in mean daily BG and hospital LOS was found with a basal insulin plus DPP-IV inhibitor regimen.
• Use of a DPP-IV inhibitor to replace bolus insulin in hospitalized patients with T2DM should be considered.

Source: SAGE Journals

5 – High-Dose Once-Weekly Semaglutide: A New Option for Obesity Management

• This study aims to review the pharmacology, efficacy, and safety of high-dose once-weekly semaglutide for chronic weight management.
• High-dose semaglutide offers significant weight-lowering potential and favorable effects on cardiometabolic risk factors and glycemic indices.
• Clinicians and patients should consider the route and frequency of administration, adverse effect profile, and cost when choosing an antiobesity medication.
• The importance of concomitant lifestyle interventions should be emphasized.
• High-dose once-weekly semaglutide can significantly reduce weight, and although gastrointestinal adverse effects were common, it is generally well tolerated.

Source: SAGE Journals

6 – Deleterious drugs in COVID-19: a rapid systematic review and meta-analysis

• Concerns have been expressed about a number of drugs that potentially worsen outcomes in patients with COVID-19.
• In this study, they sought to identify all potentially deleterious drug groups in COVID-19 and critically assess the underpinning strength of evidence pertaining to the harmful effects of these drugs.
• They found minimal high quality or consistent evidence that any drug groups increase susceptibility, severity or mortality in COVID-19.
• Converse to initial hypotheses, they found some evidence that regular use of ACEIs and ARBs prior to infection may be effective in reducing the level of care required, such as requiring intensive care, in patients with COVID-19.

Source: MedRxiv

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