Advances in Treatment of Chronic Hepatitis C Virus (HCV) Infection

Hepatitis C virus (HCV) infection is a prominent cause of chronic liver disease and may lead to serious complications such as liver failure and need for a transplant. The virus is transmitted via exposure to blood and is classified into various genotypes based on genetic mutations in the virus. Current treatment options for HCV infection are not effective in all patients, and there are limited options for patients infected with a genotype other than genotype 1. Two new medications have been approved recently for treatment of HCV infection. Simeprevir (Olysio®) gained U.S. Food and Drug Administration (FDA) approval in November 2013, and sofosbuvir (Sovaldi®) was approved in December 2013. Information from clinical trials with each of the medications supports their safety and efficacy in appropriate patient populations. The adverse effects are generally tolerable; however, for some patients, the adverse effects, drug interactions and cost can be limiting factors

Answers About the Need for Vitamin D Supplementation

Vitamin D has a significant role in bone health, calcium homeostasis, immune function and other biological functions. In our bodies, the main source of vitamin D is linked to our skin\u27s exposure to sunlight. It can also be obtained through foods that contain vitamin D. Despite these two sources, vitamin D supplementation is often necessary. It is available in two forms, cholecalciferol and ergocalciferol as over-the-counter (OTC) products, as well as calcitriol as prescription only. Reasons for vitamin D deficiency include lack of sunlight, poor diet, malabsorption of vitamin D, liver and/or kidney disease. Vitamin D deficiencies lead to diseases such as rickets, osteomalacia and osteoporosis. During supplementation it is important to monitor for vitamin D toxicity. Pharmacists need to be aware of the various guidelines regarding vitamin D supplementation

Use of Pharmacogenomics in MTM Services

Incorporation of pharmacogenomic data into Medication Therapy Management (MTM) allows pharmacists to optimize treatment regimens for patients leading to better overall outcomes. Utilizing pharmacogenomics makes it easier for health care professionals to initiate medication regimens with reduced adverse reactions, improves outcomes due to specialized dosing and therapies and allows the treatment process to be as cost-effective as possible for the patient. Pharmacists have an opportunity to educate the rest of the health care team on issues such as: which ethnicities possess higher odds of carrying certain genetic variants, the most common or most relevant medications that can have variable effects and medications that have significant severe adverse effects or hypersensitivities related to specific genetic markers. Using specific examples where medications possess variable efficacy and safety, due to differences in genetics among the patient population, helps to explain why this is such an important topic. Medications discussed in the article include carvedilol (Coreg®), dabigatran (Pradaxa®), methadone (Dolophine®), clopidogrel (Plavix®), abacavir (Ziagen®), and carbamazepine (Tegretol®). These examples emphasize why pharmacogenomic education and testing is not only relevant, but extremely important, for patients taking certain drugs. Pharmacists are in a prime position to educate other health care professionals about new, clinically relevant, pharmacogenomic findings. With knowledge of pharmacogenomics, pharmacists have the opportunity to apply population and specific individual genetic data into everyday practice, and thus can improve the efficacy and safety while being more cost-efficient