New Vaccines for Meningitis

The new guideline raises medical questions about who should get Bexsero or Trumenba to prevent meningitis. Your Pharmacist could explain that these new vaccines only protect against Meningitis B., as well as emphasis that they are not replacement for Menactra or Menveo which cover the A,C, W, and Y strains. Point out that Bexsero or Trumenba are not routinely recommended for all patients, but just for some, at higher risk of meningitis B.

Pneumococcal Vaccines for Healthy Seniors

The new CDC recommendations will change how long healthy seniors should wait between doses of different pneumococcal vaccines, could lead to seniors asking Pharmacists health questions. Adults 65 years and over, should still get both Prevnar 13 and Pneumovax 23. but now, you will need to space them at least one year apart, instead of waiting 6 months to a year, per previous guideline. Seniors need education on why both vaccines are now encouraged. Note also, that Medicare Part B will now pay for both vaccines.

HIV and Antiretroviral Therapy

More HIV patients will start their antiretroviral therapy even before they have a weakened immune system or symptoms. It is known that a lower CD4 blood cell count means a weaker immune system and a higher risk of opportunistic infections and death. New evidence reinforces that HIV patients should begin therapy, even if they have a “normal” CD4 count greater than 500 to reduce the risk of death or serious problems versus waiting until CD4 drop 350 or less. In addition, there are No more adverse effects seen with an early start.

Sinusitis: Antibiotic Use for Chronic Sinusitis

Adults with congestion, nasal discharge, or other sinus symptoms for at least 3 months often end up on antibiotics for several weeks. It is now known that chronic sinusitis is often due to inflammation NOT bacteria infection. Hence, there could be a shift away from antibiotic use for chronic sinusitis, because there is not good evidence antibiotic help. Focus on reducing inflammation instead of jumping to antibiotics. Pharmacist could recommend a nasal steroid, advise adding High-Volume nasal saline irrigation to clear mucus, and irritants from nasal passages.

Diabetes Patients and Metformin Use

Diabetes patients will need their Pharmacists help sticking with Metformin, because about 1 in 3 patients will have a GI problems with it. We know Metformin is our go-to medication, for type 2 diabetics due to well established safety and efficacy; possible CV benefit; as well as low cost. Also, it seems safer than previously thought in stable kidney disease. However, GI effects can lead to poor adherence, impacting glucose control and Srar Ratings.

Aspirin to Prevent a First Heart Attack or Stroke

The new recommendation will lead to a less use of aspirin to prevent a first heart attack or stroke. We know aspirin is beneficial to secondary prevention in patients who have already had CV event, because benefit out weigh bleeding risks. But, when to use Aspirin for primary prevention is controversial, because benefit does not always exceed risk. Now, new government recommendations will no longer suggest aspirin for most men age 45 to 79, and women 55 to 79. Pharmacists can help put benefits and risks of aspirin into perspective. Suggest aspirin 81 mg daily for men or women age 50 to 59 with a 10 years CV risk of !0% or greater, who are not at a high bleeding risk