Anticonvulsant Options for Outpatient Alcohol Detox Program

Alcoholism is a bigger issue that we like to acknowledge. From the individuals with opioid use disorder to patients with longstanding psychiatric history, their medical issues are often coupled with concerns for chronic alcoholism.  There are often limited inpatient detoxification programs available in the community. As such, options for outpatient detox program are more versatile to consider and implement especially for individuals who are in mild withdrawal (e.g. CIWA-AR below 8).

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Rotigotine – New Option for Advanced Parkinson’s Disease

I am excited to see that a new medication for Parkinson’s Disease is added to the Ontario Drug Benefits formulary. Neupro (rotigotine) is a dopamine agonist formulated as a transdermal patch and is indicated for both early and advanced stages of Parkinson’s disease as well as restless leg syndrome.

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10 Warning Signs in Dementia

World Alzheimer’s Day is coming soon – Sept 21, 2017.  After spending several years in geriatrics, I can’t help but feel compelled to do something every year. Check here for a post I wrote last year on Dementia.

This year, I have decided to be a little more creative by sharing a video on the 10 warning signs in dementia as described in Alzheimer Society Canada. Often family members don’t see the signs early enough. When treatments are started early, there is usually a greater chance in slowing the disease progression.

If you like my video, please comment, like or share. Thank you for checking out my post!

Shingles – to treat or to prevent?

I have seen few cases of Shingles recently – both confirmed and false ones which have prompted me to look closer at the current recommended approach – to treat or to prevent? Shingles or herpes zoster is caused by a varicella-zoster virus (VZV), also known as human herpes virus 3 (HHV3). It is the same virus that causes chicken pox in kids. But in Shingles, it is a result of latent reactivation within the sensory ganglia of the nervous system.

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The Role of the Pharmacist during the Opioid Crisis

As we continue to hear the impact of the opioid crisis in our communities across Canada, I wonder how pharmacists have positioned themselves in the communities to help address the concern.   Continue reading The Role of the Pharmacist during the Opioid Crisis

Any New Antiplatelet Agents for Secondary Stroke Prevention?

While prasugrel (Effient®) or ticagrelor (Brilinta®) have replaced clopidogrel (Plavix®) in the management of acute coronary syndromes, I wonder why we haven’t seen much of their infiltration in the market for secondary prevention of stroke.  Perhaps these therapies have been evaluated but the evidence has not been convincing at all. In fact, there is evidence of potential harm that is worth noting.

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Understanding Fibromyalgia

Every time when I hear the term fibromyalgia, I always need to look up what it means, its pathophysiology, clinical presentations and its guidelines and management strategies. In fact, Hauser et al recently published a review article, looking at the management of fibromyalgia.  The authors describes the various diagnostic criteria and recommendations from Canada, Germany and Israel and highlighted how they differ to a great extent in their overall approach in symptoms description, recommended investigations and screening procedures.

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