Telemedicine in Pharmacy

Telemedicine- Electronic data exchange between prescriber & pharmacy Dr. can check the PBM formulary & DUR info on their PDA PBM’s will capture more data & thus have a greater power to influence the prescriber.  Rx hub is owned by PBM. 3 types of internet pharmacies Legitimate pharmacies (minority)- like a mail order pharmacy.  Dispense … Continue reading

Pharmacy History Overview (U.S.A.)

Changing Health Priorities in America- 1700-1800: sanitation in big cities Mid1800’s-early 1900: immunizations, gov’t takes responsibility for public health Early 1900 to 1970’s: Public health has large role in overall HC.  Lots of advancements such as transplants & high tech equipment. Present:  Acute illnesses, financing for PH programs, PH is a high priority Prior to … Continue reading

Intro to Cancer

Cancer = Uncontrolled cellular growth May manifest as either a local tissue invasion or a distant metastases Incidence and mortality trends Incidence:  Prostate & breast cancer are the most common for men & women, followed by lung as 2nd for both & colorectal as 3rd for both Mortality:  Lung is the most common cause of death for … Continue reading

Acute Leukemias

Leukemia = white blood Acute leukemias are a medical emergency that require fast clinical & hematological remission or else they may be fatal Pathogenesis:  a single leukemic cell proliferates & causes an imbalance between differentiation & proliferation resulting in a “crowding out” of the bone marrow Immature cells are known as “blast cells” Risk factors for … Continue reading

Chronic Leukemias

Differences in the etiology, pathophysiology and prognostic factors of chronic leukemias Chronic myelogenous leukemia (CML) Proliferative disorder of the hematological stem cells due to a chromosomal abnormality Mainly occurs in mid-aged adults (~67), incidence increases with age Risk factors:  ionizing radiation, exposure to benzene, atomic bomb survivors s/s: no symptoms in early CML but chronic fatigue, unexplained … Continue reading

Colorectal Cancer

Risk factors for colorectal cancer Increasing age, family history of colon cancer, colon polyps (increased risk with larger & multiple polyps), inflammatory bowel disease (especially ulcerative colitis), genetic predisposition Hereditary nonpolyposis colon cancer (HNPCC) aka Lynch syndrome is an autosomal dominant disorder that has an early onset in patients (40-45 years old), polyps aren’t really … Continue reading

Lung Cancers

Risk factors for lung cancer Smoking (85% of lung cancer is due to smoking or second-hand smoke) Women at increased risk (decreased metabolism of nicotine so increased exposure to carcinogens) Radon (2nd leading cause of lung cancer) Occupational/environmental exposure:  Asbestos, arsenic, coal, petroleum Genetics, inflammatory diseases (COPD, asthma, TB, pulmonary fibrosis) Signs and symptoms for lung … Continue reading

Non-Hodgkin’s Lymphoma (NHL)

Etiology, pathophysiology and prognostic factors of Non-Hodgkin’s lymphoma (NHL). Non-Hodgkin’s Lymphoma Far more common than Hodgkin’s & is usually seen at much high age (~67) More common in males & whites Risk factors:  H. pylori, HIV< EBV, herpes, herbicides, smoking, EtOH, immune dysregulation, chromosomal abnormalities Histopathology:  monoclonal proliferation of malignant B or T lymphocytes (B cell more … Continue reading

Prostate Cancer

Risk factors for prostate cancer Being > 40, being black, a family history of relatives diagnosed at a young age, high fat intake BPH does NOT increase risk, it may delay the diagnosis though Smoking does NOT increase risk, it increases mortality though ACS screening guidelines for prostate cancer Screening is suggested beginning at 50 for … Continue reading

Skin Cancers

Risk factors for melanoma and non-melanoma Melanoma Adults, freckles, fair skin (never/minimal tanning–always getting burned), blondes, red heads, blue, green or gray eyes, being white, higher socioeconomic status Intense sun exposure, history of sunburns, > 4 painful sunburns before 15, tanning Genetic risk factors are strongly linked Ex.  Familial atypical mole syndrome, hereditary dysplastic nevus syndrome … Continue reading