There is limited evidence for the effectiveness of e-cigarettes in smoking cessation; however, there may be a place in therapy to help modify smoking habits or reduce the number of cigarettes smoked. Studies available provided different administration patterns such as use while smoking, instead of smoking, or as needed. Short-term studies reviewed were small and did not necessarily evaluate cessation with a focus on parameters associated with cessation withdrawal symptoms. Though long-term safety is unknown, concerns regarding increased poisoning exposures among adults in comparison with cigarettes are alarming.

Purpose Cilostazol (Pletal), a phosphodiesterase-3 inhi-bitor, was approved in the United States in 1999 to reduce symptoms of intermittent claudication. Cyclic adenosine monophosphate levels increase from inhibition of phos-phodiesterase resulting in anti-platelet, anti-inflammatory, and vasodilatory effects. Diabetes mellitus is a chronic disease that causes endothelial and platelet dysfunction leading to both microvascular and macrovascular compli-cations. This mini-review highlights the emerging evidence suggesting benefits of using cilostazol in treating micro-vascular complications associated with diabetes mellitus. Methods A review of literature was conducted using PubMed and Embase databases focusing on cilostazol use in diabetes mellitus. Results Cilostazol demonstrated renoprotective effects in patients with diabetic nephropathy by reducing serum soluble adhesion molecule-1 and monocyte chemoattractant protein-1. Cilostazol's anti-inflammatory actions predictably attenuate glomerular damage from increased leukocyte adherence. Additionally, cilostazol delayed renal dysfunc-tion secondary to type 2 diabetes mellitus as albuminuria was reduced most likely resulting from inhibition of nuclear factor kappa-induced inflammatory and endothelial mar-kers. Cilostazol's antiinflammatory actions in addition to its vasodilatory actions relieved retinal hypoxia and decreased excessive production of retinal blood vessels suggesting benefit in diabetic retinopathy. Cilostazol did not improve

Objective: To review the available literature that provides evidence for the absence of statin interactions with tacrolimus compared with cyclosporine. Data Sources: A literature search of PubMed was performed (1990 to June 2019) using the following search terms: calcineurin inhibitors, tacrolimus, cyclosporine, statins, atorvastatin, simvastatin, and drug interactions. Clinical practice guidelines, article bibliographies, drug interaction database references, and product monographs were also reviewed. Study Selection and Data Extraction: Relevant English-language studies describing the mechanism of interaction, the magnitude of pharmacokinetic alterations, and safety were evaluated. In vitro data and studies conducted in adult humans were considered. Data Synthesis: Studies demonstrate pharmacokinetic differences between cyclosporine and tacrolimus, particularly with regard to inhibition of 2 hepatic transporters: P-glycoprotein and organic anion transporting polypeptide (OATP). Compared with cyclosporine, tacrolimus does not affect these transporters, does not enhance statin exposure, and does not increase statin-associated safety events. Relevance to Patient Care and Clinical Practice: Clinical practice guidelines allude to the need to reduce statin doses in the setting of tacrolimus. Some providers have adopted this practice, and doing so may prevent transplant recipients from attaining cardiovascular benefit, especially when increased or high-intensity doses are required. The pharmacokinetic differences between tacrolimus and cyclosporine highlight different interaction potential with statins. Conclusions: Clinicians need to be aware that tacrolimus and cyclosporine are not the same with regard to causing drug interactions with statins. Tacrolimus can be used with statins without the need for dose adjustments because of lack of an interaction.

Patient-specific characteristics must be taken into consideration when recommending and/or prescribing PPIs to older adults.

No abstract

Objective To evaluate the prevalence of self‐reported nonmedical prescription stimulant use among college students of three northeastern pharmacy schools in the United States by examining the relationship of nonmedical use with underlying factors, academic performance, consequences associated with drug abuse, and quality of life (QOL). Methods This study was approved by the respective institutional review boards of the pharmacy schools involved. Data were collected from consenting students in their first, second, and third professional years using an anonymous survey between April and September 2017. The survey assessed underlying factors, self‐reported grade point average (GPA), and patterns of nonmedical use. Patient‐reported outcome (PRO) measures included were the Drug Abuse Screening Test (DAST‐10) to assess consequences associated with drug abuse and the Short Form (SF‐12) to measure QOL. Results In total, 651 responses of 1201 students surveyed were collected. In the included sample, 11.6% of students reported nonmedical use of prescription stimulants during college, with varying reported frequencies from 36% using once or twice to 8% using regularly. Factors associated with increased odds of nonmedical use with statistical significance included male gender (odds ratio [OR] 2.75, 95% confidence interval [CI]: 1.68‐4.52, P = 0.001) and fraternity or sorority involvement (OR 2.84, 95% CI: 1.72‐4.70, P = 0.001). Nonmedical users had statistically lower GPAs (3.38, 95% CI: 3.44‐3.50) than nonusers (3.47, 95% CI: 3.30‐3.45, P = 0.02), and increased risks associated with drug abuse, as measured by the DAST‐10. No significant differences in QOL were found between nonmedical users and nonusers, as measured by the SF‐12. Conclusion The findings examined the impact of nonmedical prescription stimulant use by pharmacy students and found that nonmedical use was similar to rates observed by college students in other studies. Nonmedical use is associated with lower GPA and increased risks associated with drug abuse. More research must be conducted to understand and increase awareness of the effects of prescription stimulants.

No abstract