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Background Cannabis contains various cannabinoids, with Δ9‐tetrahydrocannabinol (Δ9‐THC) being the primary psychoactive compound. A non‐psychoactive precursor called Δ9‐tetrahydrocannabinolic acid (THC‐A) is converted to Δ9‐THC slowly over time or rapidly when heated. Cannabis use is linked to psychotic outcomes, with increased risk associated with heavier or earlier use. Additionally, Δ9‐THC's lipophilic nature leads to prolonged detection following heavy use. These factors highlight the need for a better understanding of cannabis formulations, dosing, and their psychiatric and pharmacokinetic implications. Case Presentation This case report describes a patient who attempted suicide after developing paranoia induced by cannabis use. The patient experienced paranoid thoughts following daily consumption of 15–30 mg Δ9‐THC gummies and THC‐A in dried plant form. He reported being unfamiliar with the dosing and effects of THC‐A, which contributed to his excessive and prolonged use. Conclusion This case highlights the potential risks of consumers being unaware of the differences in cannabinoids and dosing, which can result in adverse outcomes. THC‐A, often labeled as non‐psychoactive, becomes psychoactive when heated, which can confuse users. Improved product labeling is essential to help prevent poor patient outcomes.

Background: Despite being a pillar of heart failure (HF) management, the guideline-directed initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2is) may be challenging due to the barrier of associated urinary tract infections (UTIs). Although there is a known risk, it remains unclear whether UTI incidence differs between patients with and without a prior history of UTIs. Methods: This study aimed to evaluate the risk–benefit profile of initiating an SGLT2i in patients with a history of UTIs. This retrospective, single-center healthcare system cohort analysis included adult patients hospitalized and taking an SGLT2i between 1 January 2020, and 31 August 2024. The included patients were divided into two cohorts: patients with and without a history of UTI pre-SGLT2i (described in this study as UTI-naive). Patients with urogenital structural abnormalities, indwelling catheters, or high-risk profiles were excluded. The primary outcome was the incidence of UTIs post-SGLT2i initiation. Secondary outcomes included the number of UTIs within 30, 60, and 90 days after starting an SGLT2i. Results: A total of 280 patients were evaluated for this study, of which 250 were included for analysis. Of those, 197 were UTI-naive, and 53 had a history of UTI pre-SGLT2i use. The most utilized SGLT2i was empagliflozin (75.6%). Amongst the cohorts, 20.4% of the UTI-naive patients developed a UTI post-SGLT2i versus 30.2% in patients with a historical UTI (p = 0.13). Conclusions: There was no significant difference in UTIs developed up to 90 days post-SGLT2i initiation, regardless of previous infections, suggesting that a history of UTI should not be a barrier to differing first-line therapy.

Abstract Pregabalin is a gamma-aminobutyric acid analog that binds to voltage-gated calcium channels within the central nervous tissues, inhibiting the release of many excitatory neurotransmitters. It is used to treat various conditions including postherpetic neuralgia and diabetic peripheral neuropathy. Recently, its use has increased as part of non-opioid pain management algorithms. Prolonged use in high doses of pregabalin is associated with physical dependency and abuse, which can be seen when the medication is abruptly stopped. This phenomenon has been seen in studies focused on patients having abused or grown dependent on pregabalin. However, this has not been documented in patients taking therapeutic levels in the perioperative setting. This case report highlights a patient who experienced acute withdrawal symptoms of pregabalin after coronary artery bypass and aortic root enlargement.

Every year our pharmacy programs enroll new students. Some of these students will transition smoothly, but others may not transition optimally. This transition issue can have potentially severe mental health consequences and be caused by a multitude of factors. We need to identify these factors, be able to identify at-risk students, and have programs in place to help better support our students’ mental health.

Every year our pharmacy programs enroll new students. Some of these students will transition smoothly, but others may not transition optimally. This transition issue can have potentially severe mental health consequences and be caused by a multitude of factors. We need to identify these factors, be able to identify at-risk students, and have programs in place to help better support our students' mental health.