Real Time Pharmacology

Migraine is the most prevalent neurological disorder worldwide and it has immense impact on quality of life. Release of CGRP (   calcitonin gene-related peptide)  is released during migraine  induction of migraine attacks. It causes inflammation of coverings of brain leading to pain. Two different classes of drugs blocking CGRP receptors have been developed: small molecule CGRP receptor antagonists (gepants), and monoclonal antibodies, targeting either CGRP or the CGRP receptor. Erenumab  (brand name  Aimovig) , targets the calcitonin gene-related peptide receptor (CGPCR)  for the prevention of migraine. Dosing: Migraine; Prophylaxis Injection administered in the abdomen, thigh, or upper arm subcutaneously, 70 mg subQ once a month; may go up to 140 mg subQ once a month. WARNINGS AND PRECAUTIONS-- 1. Hypersensitivity Reactions: If a serious hypersensitivity reaction occurs, discontinue administration of AIMOVIG and initiate appropriate therapy. Hypersensiti...

 Diabetes management in patients with kidney disease: Discharged this patient after medication therapy management. Family was educated about diabetes management, few medications were discontinued and others were changed. Importance of monitoring blood sugar levels was emphasized. Glyburide was discontinued; Glipizide started. Augmentin and Gabapentin were renally dosed. Lisinopril and hydrochlorothiazide were discontinued. Normal blood pressure was recorded for few days, family consulted to monitor blood pressure and check with the primary care physician. Patient's family was excited about the improvement in quality of life. Reference: Betônico CC, Titan SM, Correa-Giannella ML, Nery M, Queiroz M. Management of diabetes mellitus in individuals with chronic kidney disease: therapeutic perspectives and glycemic control.   Clinics (Sao Paulo) . 2016;71(1):47-53. doi:10.6061/clinics/2016(01)08