Impact of Student- Versus Instructor-Directed Case Discussions on Student Performance in a Pharmacotherapy Capstone Course

Objective. To evaluate the impact of incorporating student-directed (SD) vs instructor-directed (ID) active learning on student performance in a pharmacotherapy capstone course.Design. This 9-credit course was redesigned from exclusively ID case discussions to a format in which half were SD and half were ID. Student performance on evaluation questions derived from SD sessions was compared with that from ID sessions.Assessment. Overall, students (n=299) performed better on ID-session questions than on SD-session questions (78.7% vs 75.3%, correctly answered, respectively; p<0.001). For written evaluations, students performed better on ID-session questions than on SD-session questions (79.8% vs 73.9%, respectively; p<0.001). For verbal evaluations, students performed better on SD-session questions than on ID-session questions (79.5% vs 74.5%, respectively; p<0.001). After the course revision, student confidence regarding their ability to think critically, solve problems, make decisions, and pursue lifelong learning was high, and student and faculty feedback was positive.Conclusion. Student performance in a pharmacotherapy capstone course remained acceptable when a combination of SD and ID active learning was used, but the addition of SD learning did not translate to better performance on course evaluations.     

Pharmacotherapeutic options for co-morbid depression and alcohol dependence

Introduction: Depression and alcohol dependence are frequently co-morbid and among the most prevalent mental disorders. They are a serious global health problem with social, interpersonal, and legal interpolations. Among pharmacological alternatives, anti-craving compounds as well as antidepressants, antipsychotics, anticonvulsants, benzodiazepines, and beta-blockers have shown efficacy for depression as well as alcohol consumption. The pharmacological treatment of both complex interwoven mental diseases is still challenging given the inconsistent results of open and double-blind randomized placebo-controlled studies with approved and open label medications.

Areas covered: The authors provide a systematic review of the literature with PubMed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to obtain an overview of the pharmacotherapeutic options for co-morbid depression and alcohol dependence.

Expert opinion: The effect of treating only depressive or alcohol-related symptoms appears limited. Therapies directly targeting the addiction are warranted among such dually diagnosed patients. Despite limited data, the reviewed pharmacotherapeutic treatments demonstrated efficacy in most but not in all relevant parameters of alcohol dependence and depression.     

COVID-19 managed with early non-invasive ventilation and a bundle pharmacotherapy: A case report

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has become an immense public health burden,first in China and subsequently worldwide.Developing effective control measures for COVID-19,especially measures that can halt the worsening of severe cases to a critical status is of urgent importance.CASE SUMMARY A 52-year-old woman presented with a high fever(38.8°C),chills,dizziness,and weakness.Epidemiologically,she had not been to Wuhan where COVID-19 emerged and did not have a family history of a disease cluster.A blood test yielded a white blood cell count of 4.41×109/L(60.6±2.67%neutrophils and 30.4±1.34%lymphocytes).Chest imaging revealed bilateral ground-glass lung changes.Based on a positive nasopharyngeal swab nucleic acid test result and clinical characteristics,the patient was diagnosed with COVID-19.Following treatment with early non-invasive ventilation and a bundle pharmacotherapy,she recovered with a good outcome.CONCLUSION Early non-invasive ventilation with a bundle pharmacotherapy may be an effective treatment regimen for the broader population of patients with COVID-19.     

Treating obesity in patients with cardiovascular disease: the pharmacotherapeutic options

Introduction: Obesity is a growing health problem that has numerous comorbidities, including cardiovascular disease (CVD). The multi-disciplinary treatment of obesity now includes the use of pharmacotherapy. When treating patients with obesity and CVD, certain medications may be more appropriate than others.

Areas covered: Herein, the authors review the most commonly used FDA approved medications for the treatment of obesity, describing their mechanism of action, and the efficacy and safety of the medications as seen in recent studies, particularly in patients with CVD.

Expert opinion: In the population of patients with obesity and CVD, the medications orlistat, lorcaserin and liraglutide are considered the most appropriate options for their treatment, in terms of safety. Sympathomimetic medications, such as phentermine, should be avoided in this group. The recent CAMELLIA-TIMI 61 trial supports the safety of lorcaserin in patients with CVD. Until there are more studies, it is reasonable to extrapolate the findings of the LEADER trial, which found improved CV outcomes in subjects with type 2 diabetes taking liraglutide, to the population of nondiabetic patients being treated for obesity. Further cardiovascular outcomes trials (CVOT) are needed to assess the safety of other pharmacotherapeutic options for weight loss.     

Pregabalin in acute treatment of anxious depression: A case series

Symptoms of anxiety are common in patients with depression. In this retrospective case series we investigated the effect of Pregabalin as an add-on medication in unipolar depressed patients with high levels of anxiety. The therapeutic effect of Pregabalin showed a fast onset and was comparable to the anxiolytic effect of benzodiazepines.     

Interventions for alcohol-related brain damage (ARBD): Do specific approaches restrict the evolution of comprehensive patient care?

Aims: The prevalence of alcohol-related brain damage (ARBD) is recognized to be increasing in the Western world. The aim of this article is to review the evidence concerning interventions in ARBD. Design and methods: Systematic review. Findings: About 469 papers were identified of which 49 were suitable for inclusion. About 20 concerned neuropsychological interventions; 5 detailed psychosocial interventions; and 24 focussed on pharmacological interventions. The findings suggest that a range of cognitive rehabilitation strategies can facilitate new learning and improve memory functioning, while psychosocial interventions and supported accommodation can improve mental and physical health. Conclusions: This review demonstrates the need for a comprehensive approach to ARBD rehabilitation and indicates that the management of this condition has not been investigated in a holistic manner.