Medicines optimisation measures, warfarin-tramadol interaction and icosapent ethyl

In this podcast recorded in early August, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the September issue of DTB. They discuss the editorial (https://dtb.bmj.com/content/62/9/130) that highlights some of the challenges associated with NHS England's national medicines optimisation measures for Integrated Care Boards. They talk about the MHRA's recent safety alert on the risk of an interaction between tramadol and warfarin (https://dtb.bmj.com/content/62/9/131), which was prompted by a coroner's prevention of future deaths report (summarised in a DTB article in March https://dtb.bmj.com/content/62/3/36). The main article reviews the evidence for icosapent ethyl for cardiovascular risk reduction (https://dtb.bmj.com/content/62/9/135).   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email [email protected]. Thank you for listening.

In this podcast recorded in early July, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) continue to ignore political and sporting events and talk about the August issue of DTB. They discuss the editorial that highlights the growth in the use of psychotropic medication in children and young people and some of the challenges associated with this trend. They talk about a study that assessed the harms of changing frail older people with AF from warfarin to a DOAC. The main article is an overview of the evidence for fezolinetant for the treatment of menopausal vasomotor symptoms.   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email [email protected]. Thank you for listening.

In this podcast recorded in early June, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) ignore the UK general election, the T20 cricket world cup and the European football championship and talk about the July 2024 issue of DTB. They discuss the editorial that highlights trial data showing that dupilumab had a modest effect on reducing COPD exacerbations, and question whether more drugs or greater investment in pulmonary rehabilitation and smoking cessation services are a better use of resources. They review a coroner's prevention of future deaths report that highlights the need to raise awareness of the dangers of propranolol overdose. The main article discusses the management of exacerbations of COPD in primary care.   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email [email protected]. Thank you for listening.  

In this podcast recorded in early May, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the June 2024 issue of DTB. They discuss the editorial that highlights changes to the use of gonadal and fetal shielding for diagnostic imaging (see link). They review the results of a study that assessed the benefit of antibiotics for treating acute sinusitis in children aged 2-11 years.  The main article considers the evidence for ritlecitinib, a Janus kinase enzyme inhibitor that is licensed for the treatment of severe alopecia areata in adults and adolescents aged ≥12 years. They begin the podcast by discussing newspaper headlines generated by an international conference on obesity. Link https://www.bir.org.uk/education-and-events/patient-shielding-guidance.aspx Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). If you want to contact us please email [email protected]. Thank you for listening.

In this podcast recorded in early April, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the May 2024 issue of DTB. They discuss the editorial that highlights the effect medicines have on greenhouse gas emissions and the need to consider the environmental impact of all aspects of the patient care pathway​ (https://dtb.bmj.com/content/62/5/66). They review the results of a study that assessed the effect of donanemab on early symptomatic Alzheimer's disease​ (https://dtb.bmj.com/content/62/5/67). The main article considers the evidence for cytisine, a nicotine receptor partial agonist, that has recently been licensed to facilitate quitting smoking​ (https://dtb.bmj.com/content/62/5/71). They begin by highlighting some useful resources relating to the safe use of valproate.   Other links: https://www.england.nhs.uk/patient-safety/sodium-valproate/  https://www.england.nhs.uk/publication/decision-support-tool-is-valproate-the-right-epilepsy-treatment-for-me/ https://www.gov.uk/government/collections/valproate-safety-measures https://www.gov.uk/guidance/valproate-use-by-women-and-girls   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). If you want to contact us please email [email protected]. Thank you for listening.  

In this podcast recorded in early March, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the April 2024 issue of DTB. They discuss the editorial that questions whether drug safety alerts are effective in changing practice and whether more needs to be done to implement safety recommendations (https://dtb.bmj.com/content/62/4/50). They review the Medicines and Healthcare products Regulatory Agency's latest risk minimisation measures for using valproate, which include a guide for healthcare professionals, a guide for patients, an annual risk acknowledgement form and an information card for patients (https://dtb.bmj.com/content/62/4/53). The main article considers the evidence for a new progestogen only pill containing drospirenone (https://dtb.bmj.com/content/62/4/55). They begin by discussing recent concerns over neuropsychiatric reactions associated with montelukast. Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). If you want to contact us please email [email protected]. Thank you for listening.

In this podcast recorded in early February, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the March 2024 issue of DTB. They discuss the editorial highlighting the important work that the founders of The Medical Letter, Worst Pills, Best Pills and Drug and Therapeutics Bulletin did to scrutinise the safety of medicines and the need to challenge the processes by which medicines are licensed, appraised, commissioned and promoted (https://dtb.bmj.com/content/62/3/34). They review a coroner's Prevention of Future Deaths report that highlighted an interaction between tramadol and warfarin (https://dtb.bmj.com/content/62/3/36). They also talk about a study that compared the emergency contraceptive efficacy of levonorgestrel plus piroxicam with levonorgestrel plus placebo (https://dtb.bmj.com/content/62/3/38). The main article considers the effectiveness of low or very low calorie diets in achieving remission of type 2 diabetes (https://dtb.bmj.com/content/62/3/39).   Link Mathew R. Prescribing isn’t a single act—getting it right requires time and effort. BMJ 2024;384:q279 (https://www.bmj.com/content/384/bmj.q279) Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). If you want to contact us please email [email protected]. Thank you for listening.

In this podcast recorded in early January, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the February 2024 issue of DTB. They discuss the editorial that highlights problems associated with shortages of ADHD medicines.  They talk about two safety alerts issued by the Medicines and Healthcare products Regulatory Agency that focus on the adverse effects of fluoroquinolone antibiotics on physical and mental health.  The main article considers various NHS initiatives that have attempted to limit primary care prescribing of drugs that are deemed to have limited clinical value. They begin the podcast with sad news of the death of Dr Sidney Wolfe (1937-2024), a colleague and friend who co-founded the US Health Research Group and Public Citizen (a nonprofit consumer advocacy organisation) and who was "a towering public health leader and an unparalleled consumer champion".    Links Remembering Sid Wolfe: https://www.citizen.org/remembering-sidney-wolfe/ Mandatory disclosure of all pharmaceutical and medical device companies’ payments to healthcare providers: learning from the US: https://dtb.bmj.com/content/60/4/52 Worst Pills, Best Pills: https://www.citizen.org/topic/safe-affordable-drugs-devices/worst-pills-best-pills/ Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). If you want to contact us please email [email protected]. Thank you for listening.

In this podcast recorded in BMA House in December, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the January 2024 issue of DTB. They discuss continuity of care in general practice and the benefits it offers (https://dtb.bmj.com/content/62/1/2). They discuss a safety alert issued by the Medicines and Healthcare products Regulatory Agency that highlights a very small number of reports of new-onset or aggravation of pre-existing myasthenia gravis associated with statins (https://dtb.bmj.com/content/62/1/4). The main article is an overview of the management of acne (https://dtb.bmj.com/content/62/1/6). They begin the podcast by providing a brief update on the results of a trial that assessed the effect of semaglutide on cardiovascular outcomes in people aged ≥45 years with cardiovascular disease (but not diabetes) and a BMI ≥27 kg/m2 (plot spoiler: make sure you know your ARRs from your RRRs). Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). If you want to contact us please email [email protected]. Thank you for listening.

In this podcast, James Cave (Editor-in-Chief) and David Phizackerley (Deputy Editor) talk about the December 2023 issue of DTB. They discuss monitoring drugs in primary care and the need to rationalise the number of blood tests undertaken (https://dtb.bmj.com/content/61/12/178). They talk about a study that reported the effect of bempedoic acid on a composite cardiovascular outcome (https://dtb.bmj.com/content/61/12/180). The main article is a review of semaglutide as an option for weight management and discusses the evidence for its use and some of the hype that has surrounded the its launch (https://dtb.bmj.com/content/61/12/182). They begin by responding to a listener's complaint about terminology.   Related link: Aronson JK. When I use a word . . . Medicines regulation—apothecaries, quacks, chemists, druggists, pharmacists. BMJ 2023;383:p2603. https://www.bmj.com/content/383/bmj.p2603    Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page (https://podcasts.apple.com/gb/podcast/dtb-podcast/id307773309). If you want to contact us please email [email protected]. Thank you for listening.