Podcast
Pharmacy Focus
Hosted by Pharmacy Times · EN
The Pharmacy Times® Pharmacy Focus podcast provides the latest industry news and information, thought-leader insights, clinical updates, patient counseling tools, and innovative solutions for the everyday practice and business of pharmacy. Winner of the 2021 Digital Health Media/Publications Audio Merit Award.
36episodes
Episodes
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S2 Ep88: CMSC 2026 Highlights: Biomarkers, DMT Discontinuation, and Pregnancy Planning in MS
1w ago00:54:44Tap to summarizeIn this episode of Mind the Meds, host Erica Marini, PharmD, MS, BCPS, welcomes Jenelle Hall Montgomery, PharmD, BCACP, CPP, a clinical pharmacist practitioner with Duke Neurological Disorders Clinic at Duke University Hospital, to discuss highlights from the Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting in Charlotte, North Carolina, where Montgomery was recognized as a Giant of Multiple Sclerosis. Before the CMSC discussion, Marini runs through a roundup of recent neurology news, including approval of at-home initiation dosing for lecanemab-irmb (Leqembi; Eisai, Biogen), fast track designation for remlifanserin (Acadia Pharmaceuticals) in Alzheimer disease psychosis, approval of the oral PCSK9 inhibitor enlicitide (Lipfendra; Merck), and phase 3 data on tavapadon (AbbVie) for Parkinson disease showing a lower rate of impulse control disorders than traditional dopamine agonists.The pharmacists then turn to CMSC sessions on off-label and evolving areas of MS care. They discuss growing interest in neurofilament light chain as a biomarker for tracking subclinical disease progression over time, along with the ongoing debate over when it is safe to discontinue disease-modifying therapy (DMT) in older, stable patients. Both note their practices generally begin this conversation around 60 to 65 years of age, factoring in radiographic and clinical stability over the preceding decade, and describe strategies such as tapering dosing frequency or switching to lower-efficacy agents rather than abrupt discontinuation.The conversation closes with an update on family planning in MS, where new data presented at CMSC reinforce the safety of anti-CD20 therapies during pregnancy and breastfeeding. Montgomery and Marini review a 10-year dataset of about 5000 pregnancies on ocrelizumab (Ocrevus; Genentech), a large safety analysis of ofatumumab (Kesimpta; Novartis Pharmaceuticals) showing no increase in birth malformations, and early transfer-into-breastmilk data on ublituximab (Briumvi; TG Therapeutics). They also touch on the limited but growing evidence for GLP-1 receptor agonists in patients with MS, noting no known drug interactions with DMTs and possible indirect benefit through weight-related disease modulation, though neither pharmacist currently prescribes GLP-1s for an MS indication.Key Takeaways:1. Neurofilament light chain is emerging as a useful, though not yet mainstream, biomarker in MS. Rather than a single value, tracking neurofilament light chain over time alongside clinical status may help identify subclinical disease progression, particularly in patients without clear relapses.2. DMT discontinuation in older, stable patients remains individualized, with most practices starting the conversation around 60 to 65 years of age. Clinicians weigh 10-year clinical and radiographic stability, and some patients opt for a gradual step-down in dosing frequency or a switch to a lower-efficacy agent rather than outright discontinuation.3. New pregnancy and breastfeeding safety data continue to support anti-CD20 therapies as a preferred family planning strategy in MS. A 10-year, 5000-pregnancy dataset on ocrelizumab, reassuring malformation data on ofatumumab, and early breastmilk transfer data on ublituximab are strengthening patient counseling conversations around conception, pregnancy, and postpartum DMT resumption.
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S2 Ep87: EP. 1: Introducing Pharmacy Focus: Financial Wellness—Building Your Rich Life
2w ago00:10:24Tap to summarizeHave a question, feedback, or an idea for a future episode? Contact YFP Wealth at info@yfpwealth.com. To learn more about fee-only financial planning services for pharmacists, visit yfpwealth.com.This podcast is for informational purposes only and should not be considered investment or financial advice. Visit yfpwealth.com/disclaimer for more information.
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S2 Ep86: Untangling Holistic, Integrative, Functional, and Precision Medicine in Oncology
3w ago00:37:01Tap to summarizeHolistic, integrative, functional, precision—the labels are everywhere, but few patients or clinicians know where one ends and the next begins.
Transcribe →S2 Ep84: Beyond Seizures: Phenobarbital's Clinically Significant Interaction Profile
Jul 200:53:24Tap to summarizeTo open the episode, Erica Marini, PharmD, discussed a roundup of FDA and research updates in neurology. She covered the shifting accelerated-approval pathway for AMT-130 (uniQure), a gene therapy for Huntington disease, and a similar back-and-forth for a Hunter syndrome gene therapy. She also noted an expanded indication for olezarsen (Tryngolza; Ionis Pharmaceuticals) in severe hypertriglyceridemia, a UK study linking hypotension to Alzheimer risk, and data suggesting shingles vaccination may lower dementia risk in Medicare beneficiaries. From the American Headache Society meeting, she highlighted phase 2b data on the TRPM8 agonist elismotrep (Kallyope), and the anti-PACAP antibody bocunebart (Lundbeck) for migraine, along with retrospective findings tying CGRP monoclonal antibodies to increased fracture risk and higher odds of spontaneous abortion in early pregnancy.The core interview featured Adrian Wong, PharmD, MPH, BCCCP; and Cayley Krkljes, PharmD, BCPS, of Beth Israel Deaconess Medical Center who discussed a systematic review published in Pharmacotherapy of clinically significant drug-drug interactions with phenobarbital and primidone. Wong and Krkljes described growing use of phenobarbital for alcohol withdrawal and note that health care professionals often underappreciate its interaction potential despite it being a well-known enzyme inducer. Key findings included an induction onset of 24 hours to 30 days and an offset of 2 to 8 weeks, findings that carry particular weight for transitions of care since inpatient dosing effects can persist well after discharge. The most clinically impactful interactions involved anticoagulants (warfarin and direct oral anticoagulants [DOACs]), methadone, and immunosuppressants, with approximately 85% of reviewed studies reporting some outcome impact. They also pushed back on recent social media claims that phenobarbital-DOAC interactions are not clinically relevant, pointing out methodological limitations in the studies behind that claim.The conversation moved into practical risk stratification: The guests described considering a patient's individual risk factors—such as recent thrombosis, transplant status, or opioid use disorder treatment with methadone or buprenorphine—before choosing phenobarbital over benzodiazepines for alcohol withdrawal. They outlined next steps for research, including studying real-world outcomes in high-risk medication combinations and surveying health care professional awareness of these interactions to identify education gaps. The episode closed with career advice for pharmacists interested in research—start small, find mentors, and leverage institutional resources.Key Takeaways: Phenobarbital's interaction risk is widely underrecognized. Despite growing use for alcohol withdrawal, phenobarbital's enzyme-inducing effects can persist for weeks after the last dose (onset 24 hours to 30 days; offset 2 to 8 weeks), making transitions of care a critical window for catching interactions—especially with anticoagulants, methadone, and immunosuppressants, which accounted for the most clinically impactful outcomes in the review. Not all "reassuring" data holds up under scrutiny. Wong and Krkljes challenged circulating social media claims that phenobarbital-DOAC interactions aren't clinically relevant, noting the studies behind those claims had methodological limitations, emphasizing the importance of evaluating primary literature rather than secondhand interpretations. Risk stratification should guide phenobarbital use. Individual patient factors (eg, recent thrombosis, transplant status, or opioid use disorder treatment with methadone or buprenorphine) should inform whether phenobarbital or a benzodiazepine is the safer choice for alcohol withdrawal management.
Transcribe →S2 Ep83: Operationalizing ASTCT Infectious Disease Guidelines: A Pharmacist Perspective on CMV, HHV-6, and Fungal Prophylaxis
Jun 2500:38:02Tap to summarizeUpdated ASTCT infectious disease guidelines are reshaping how BMT and cellular therapy pharmacists approach prophylaxis, treatment thresholds, and drug–drug interactions across a range of opportunistic infections.
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S2 Ep82: World Psychedelics Day: Why Pharmacy Can't Sit This One Out
Jun 2000:43:01Tap to summarizeFind out more information about the Psychedelic Pharmacists Foundation (PPF) & Psychedelic Pharmacists Association (PPA):PPF: https://www.psychedelicpharmacistsfoundation.org/PPA: https://psychedelicpharmacist.org/
Transcribe →S2 Ep81: Cancer Prevention, Misinformation, and Modern Wellness
Jun 1600:39:51Tap to summarizeThe discussion examines the evidence behind common concerns about everyday products, food trends, and lifestyle habits, while emphasizing a practical, individualized approach to health and cancer prevention.
Transcribe →S2 Ep80: It Takes a Village: Bringing Cell & Gene Therapy to Patients
Jun 500:46:08Tap to summarizeA panel of clinical pharmacists meets to discuss the complex process of operationalizing cell and gene therapy at an academic medical center.
Transcribe →S2 Ep79: Alzheimer Updates, Stroke Breakthroughs, and the Case for Early Treatment
Jun 400:52:33Tap to summarizeIn this episode of Mind the Meds, Erica Marini, PharmD, highlights information from the European Stroke Organization Conference include encouraging data on asundexian(Bayer), a factor XIa inhibitor showing reduced recurrent ischemic stroke risk without increased bleeding, as well as positive results from three trials of tirofiban in acute ischemic stroke settings. On the multiple sclerosis (MS) front, Marini covers the FDA approval of ocrelizumab (Ocrevus; Genentech) for pediatric relapsing-remitting MS in children 10 and older, a new study supporting early use of high-efficacy agents in pediatric MS, and 2 Lancet publications on ocrelizumab — one examining higher weight-adjusted dosing (which did not improve disability progression) and one confirming benefit in a broader primary progressive MS population. She also briefly discusses PADOVA (NCT04777331), a phase 2b trial of prasinezumab in early Parkinson's disease, which failed to meet its primary end point.The bulk of the episode is a discussion with guest Millad Sobhanian, PharmD, BCPS, clinical pharmacy specialist in neurology at the University of Maryland, focused on Alzheimer disease. They cover dextromethorphan/bupropion (Auvelity; Axsome Therapeutics), newly approved in April 2026 for agitation associated with Alzheimer dementia. Sobhanian walks through key safety considerations—including additive NMDA antagonism if combined with memantine, cardiovascular risks from the bupropion component, and the ever-present black box warning on antipsychotics in dementia patients—while both note that the efficacy data, though statistically significant, shows modest clinical effect sizes compared to the threshold for meaningful within-patient change.The conversation then turns to lecanemab's subcutaneous initiation formulation (Leqembi Iqlik; Eisai, Biogen), whose FDA decision has been delayed to about August 2026 as regulators seek more data on bioavailability and ARIA monitoring in the at-home setting. Sobhanian shares his real-world perspective on anti-amyloid therapy, describing a patient population that is typically early-stage, high-functioning, and has a mean age of about 60 to 70 years, and emphasizing the pharmacist's role in expectation-setting around the modest but potentially cumulative slowing of cognitive decline. The episode closes with a thorough discussion of the April 2026 Cochrane review on amyloid-targeting monoclonal antibodies, which both Marini and Sobhanian find overly broad in its conclusions. They note limitations such as the inclusion of withdrawn agents like aducanumab (Aduhelm; Biogen), heterogeneous inclusion criteria across trials, and an 18-month study horizon that may be too short to capture the full benefit suggested by longer-term open-label extension data.Key Takeaways:1. New options for Alzheimer's agitation exist, but fit carefully into the treatment algorithm. Dextromethorphan/bupropion offers a novel NMDA-based mechanism for treating agitation in Alzheimer dementia, but its clinical effect size is modest, and it carries meaningful safety considerations—particularly around the bupropion component in elderly patients. Like all pharmacologic options in this space, it remains a later-line choice after nonpharmacologic interventions have been exhausted, and medication reconciliation is critical given its interaction potential with memantine and CYP2D6 inhibitors.2. Anti-amyloid therapies are imperfect but not ready to be written off. The April 2026 Cochrane review drew significant attention with its conclusion that anti-amyloid monoclonal antibodies produce only trivial cognitive benefits, but its findings are limited by the inclusion of older, withdrawn agents, heterogeneous trial populations, and an 18-month time horizon that may be too short to capture the full trajectory of benefit.3. The pharmacist's role in anti-amyloid therapy goes well beyond dispensing. As illustrated by Sobhanian's practice at the University of Maryland, clinical pharmacists embedded in neurology clinics play a critical role in patient selection, expectation-setting, ARIA counseling, and informed decision-making for patients considering anti-amyloid therapy—a complex, high-stakes treatment decision that these patients and their caregivers should never be navigating alone.
Transcribe →S2 Ep76: Innovations in Psychiatric Pharmacotherapy From the AAPP Annual Meeting
May 2000:29:21Tap to summarizeIn this episode of Pharmacy Focus, moderator Bob Haight, PharmD, BCPP, AAPP Annual Meeting director and past president of American Association of Psychiatric Pharmacists (AAPP), discusses the AAPP 2026 Annual Meeting with Archana Jhawar, PharmD, BCPP, clinical assistant professor at the University of Illinois Chicago; and Chelsea Di Polito, PharmD, BCPP, psychiatric clinical pharmacist at the University of Maryland, Baltimore. The discussion centers on emerging trends in psychiatric pharmacotherapy across diverse practice settings. A major focus is on newer psychiatric medications, including sublingual dexmedetomidine for acute agitation, which offers a novel, patient-friendly administration route and potential benefits for inpatient care. Additional discussion covers agents like lumateperone and xanomeline-trospium, with attention to their safety profiles, tolerability, and evolving roles in treatment. The speakers emphasize the importance of real-world experience in determining how these newer therapies fit into clinical decision-making, especially given considerations like cost, monitoring requirements, and patient-specific factors.The episode also explores cutting-edge research and practice challenges, including the growing interest in GLP-1 receptor agonists for substance use disorders. While still considered “unproven but promising,” early data suggest these agents may reduce addictive behaviors by modulating reward pathways rather than through traditional metabolic effects. Additional highlights include evolving strategies for clozapine monitoring following REMS changes, where pharmacists play a central role in balancing safety and access, and advancements in long-acting injectable antipsychotics that improve flexibility, adherence, and patient-centered care. Across all topics, a consistent theme emerges: the expanding range of treatment options requires clinicians to stay informed, adaptable, and focused on individualized care. The speakers conclude that AAPP’s annual meeting provides a valuable forum for translating emerging evidence into practical strategies that can be immediately applied in clinical practice.Read more about the AAPP here: https://aapp.org/ed/meeting/2026Additional information on the AAPP Annual meeting can be found here: https://aapp.org/ Key Takeaways: New psychiatric treatments are expanding options but require real-world context. Emerging therapies—such as sublingual dexmedetomidine, lumateperone, and xanomeline-trospium—offer novel mechanisms, improved tolerability, and alternative administration routes. However, clinicians are still determining where these agents fit in practice, making shared clinical experience and practical insights critical for informed use. Innovative research is reshaping how clinicians think about psychiatric and substance use treatment. GLP-1 receptor agonists are gaining attention for substance use disorders, with early evidence suggesting they may reduce addictive behaviors by acting on reward pathways. While still investigational, this highlights a broader shift toward targeting underlying neurobiology rather than just symptoms. Pharmacists play a central role in navigating evolving care models and improving patient outcomes. From optimizing clozapine monitoring after REMS changes to implementing long-acting injectable antipsychotics, pharmacists are key in balancing safety, access, adherence, and education. Their involvement is essential as treatment options become more complex and patient-centered.
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