PHARMACOM LLC
A Consulting Company
August 2020
Marijuana Use Risky in Cardiovascular Disease
Medicinal and recreational use of marijuana is increasing. A recent review highlighted risks of marijuana use in patients with cardiovascular (CV) disease. Smoking marijuana carries many of the same CV risks as smoking tobacco. Acute effects of marijuana include increases in heart rate and blood pressure, and activation of cannabinoid receptors in the CV system may increase oxidative stress, inflammation, and fibrosis. Marijuana use also increases the risk of drug-drug interactions. Marijuana components inhibit cytochrome P450 enzymes, which may increase the effects of calcium channel blockers, statins, beta-blockers, vitamin K antagonists, NSAIDs, and antiarrhythmic medications used by patients with CV disease.
Opioid Epidemic Continues
Attention is currently focused on the coronavirus pandemic, but the opioid epidemic continues. An article published in the New England Journal of Medicine describes several myths and realities about opioid prescribing. One myth is that opioids are the most powerful and effective painkillers. However, there is little evidence that opioids are routinely better than NSAIDs, muscle relaxants. or other pain medications. Another myth is that there is little risk of misuse or dependence with short courses of opioids. Dependence can develop very quickly, and even short-term use of opioids increases the risk of addiction in the future. Opioids do have a role in pain management, particularly in patients whose pain is not managed with other pain relievers and in a small subset of patients who live with chronic pain.
Mixed Messages about Sunscreens
Patients may be getting mixed messages about the use of sunscreens. Some chemical sunscreens will be phased out of products because they cause damage to coral reefs in the ocean. Other chemical sunscreens are known to be absorbed into the bloodstream. However, it is not known if the systemic absorption of these chemicals causes harm in humans. What is known is that daily use of sunscreen lowers the risk of skin cancer. Many types of sunscreens are available, and the best product is the one that the patient will use regularly and properly. Sunscreens should offer protection against UVA and UVB rays and have a sun protection factor of at least 15. The sunscreen should be applied liberally 15 minutes before sun exposure and re-applied every 2 hours or immediately after swimming. "Mineral" sunscreens use titanium dioxide or zinc oxide rather than chemicals to protect the skin. An alternative to applying chemical or mineral sunscreens is wearing clothing with UV protection.
August is Summer Sun Safety Month
August is National Breastfeeding Month
August is National Immunization Awareness Month
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