As a clinical pharmacist, patients will need your help managing long COVID, when symptoms linger more than 12 weeks after initial infection. COVID-19 can leave lasting effects anywhere in the body, causing "brain fog", diarrhea , shortness of breath, etc. Symptoms seem to be more common in patients who’ve had severe COVID-19 (hospitalized, etc), a repeat in…
Read moreAs a pharmacist, you’ll hear buzz about molnupiravir ( Lagevrio ) , the first oral antiviral to treat COVID-19, now that it’s under FDA review. Molnupiravir blocks viral replication by incorporating itself into the RNA of SARS-CoV-2 causing viral death. It’s 4 capsules BID for 5 days and seems well tolerated. Preliminary evidence suggests mol…
Read moreAs a pharmacist, you’ll get more questions about COVID-19 vaccines for kids, now that the Pfizer-BioNTech vaccine is authorized down to age 5. Early evidence in 2300 kids age 5 to 11 suggests this vaccine has about 90% efficacy at preventing symptomatic COVID-19. Plus data in 4600 kids suggest side effects are similar to those seen in older patients. …
Read moreAs a pharmacist, you’ll need to clear up confusion about COVID-19 vaccines, now that Moderna and Johnson & Johnson/Janssen boosters are authorized. But also keep the focus on vaccinating UNimmunized patients. Terminology. Clarify that “boosters” aim to maintain protection after an adequate initial immune response. “Additional doses” are for patients who likely …
Read moreCasirivimab/imdevimab will be the second monoclonal antibody treatment authorized for OUTpatients with COVID-19. This combination will be an alternative to bamlanivimab as a single-dose IV infusion. And more are in the works. These "mabs" block SARS-CoV-2 from entering cells. Evolving evidence suggests bamlanivimab may not be …
Read morePatients will ask whether COVID-19 vaccines increase clot risk. This is due to reports of serious blood clots along with low platelets after the Johnson & Johnson/Janssen vaccine in the U.S and the AstraZeneca vaccine in other countries. Both are viral vector vaccines. Now the Janssen vaccine emergency use authorization (EUA) fact sheets will warn about this …
Read moreBamlanivimab/etesevimab will be the third monoclonal antibody option authorized to treat OUTpatients with COVID-19. This combo joins bamlanivimab and casirivimab/imdevimab as another single-dose IV infusion. And more are in the works. These “mabs” block SARS-CoV-2 from entering cells. Combination products may also limit treatment-em…
Read moreAs a pharmacist, you'll be asked whether OUTpatients with COVID-19 should be treated with inhaled corticosteroids, colchicine, or fluvoxamine. Inhaled steroids and oral colchicine are getting buzz for their anti-inflammatory effects and fluvoxamine may regulate cytokines. But emphasize that it's too soon to recommend any of these medications or other oral &qu…
Read moreAs a hospital pharmacist, you will hear renewed interest in tocilizumab for COVID-19, based on new data suggesting it reduces mortality in some patients. IL-6 inhibitors, such as tocilizumab ( Actemra ), sparked early interest in COVID-19 to block cytokines and reduce inflammation. But trials haven’t consistently demonstrated a benefit. Now early data from the R…
Read moreClinicians are scrambling to optimize venous thromboembolism (VTE) prophylaxis for hospitalized patients with COVID-19. Data suggest these patients have a higher VTE risk than other hospitalized patients. Plus D-dimer and other markers are often elevated in COVID-19 especially in severe cases. But there’s little evidence about optimal VTE prophylaxis in patients wi…
Read moreWhich adults should receive mRNA COVID-19 vaccine? Almost everyone . The Pfizer-BioNTech and Moderna products are not live vaccines, and benefits typically outweigh theoretical risks. Urge patients to get either vaccine series when eligible. History of allergic reactions. Vaccinate most patients with a prior severe reaction to food, latex, or oral medicati…
Read moreThe oral rheumatoid arthritis medication baricitinib ( Olumiant ) is now authorized to treat COVID-19 in hospitalized patients. It's a Janus kinase (JAK) inhibitor that blocks cytokines to decrease inflammation. Plus it may have antiviral effects. Explain that evidence suggests ADDING baricitinib to remdesivir ( Veklury ) reduces recovery time by 1 day, comp…
Read moreRemdesivir ( Veklury ) IS FDA-approved for all hospitalized COVID-19 patients who are at least 12 years old and weigh 40 kg or more. But this doesn't mean it should be used more. And conflicting guidelines add to the confusion. Be prepared to explain remdesivir's current role, especially compared to dexamethasone... In pa…
Read moreMore than 4 in 10 people have increased their use of supplements since the start of the COVID-19 pandemic. Reinforce that there's still no evidence any supplement helps prevent or treat COVID-19. Not all supplements are risky. But clarify which products to avoid. Many patients swear by "immune boosters" such as colloidal silver, echinacea, green tea, se…
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