In her 1978 work of critical theory, Illness as a Metaphor, Susan Sontag offered...
In her 1978 work of critical theory, Illness as a Metaphor, Susan Sontag offered the following: “Everyone who is born holds dual citizenship, in the kingdom of the well and the kingdom of the sick.”
It is essential that the lower extremity provider, when making decisions regarding which medications to prescribe, employs the knowledge of pharmacology, adverse medication effects as well as drug interactions. Physicians are trained to realize that medication response is not the same in every patient. It must be acknowledged that pharmacological regimens do not exist in a vacuum. The science of pharmacology and pharmaceutical manufacturing continually evolves and advances. It is crucial that healthcare providers select agents of therapy based on up-to-date information.
In this issue’s feature article, I included the phrase “Veneni dextera dextrae Tempus” — Latin for “Right drug right time” — as a metaphor for the available clinical-based evidence within the evolving science of pharmacology. It is imperative that clinicians familiarize themselves and stay updated on how given medications may act differently depending on patient factors and pathophysiology. For this reason, the feature article encompasses a review of tools to assist in prescribing newer medications with an exploration of critical elements that affect patient response.
This issue’s abstracts and commentaries pertain to updated relevant pharmacology issues, some that may be controversial in the context of evolving ideology for enhancing medication response while mitigating negative interactions.
The first audio lecture is centered on avoiding drug injury and responsibilities of the lower extremity physician in detailing medical and legal aspects that the lower extremity specialist should consider so to avoid drug-induced injury. The second audio presentation focuses on new medications that have reshaped treatment options in our realm of care. This lecture explores medications that have recently come to market, noting each agent’s pharmacology, directions for use, adverse drug profile and cost to patients. This issue reviews many of the advances and updates regarding the changing viewpoints of pharmacotherapy, so that the practicing foot and ankle specialist can select appropriate pharmacological agents for their diverse patient population with confidence.
The ideas and opinions expressed in Foot and Ankle Quarterly are those of the authors and do not necessarily reflect those of the Editor or the Publisher. Publication of an advertisement or other product mentioned in Foot and Ankle Quarterly should not be construed as an endorsement of the product of the manufacturer’s claims. Readers are encouraged to contact the manufacturer with any questions about the features or limitations of the products mentioned. The Publisher does not assume any responsibility for any injury and/or damage to any persons or property arising out of or related to any use of the material contained in this periodical. The reader is advised to check the appropriate medical literature and the product information currently provided by the manufacturer of each device or of each drug to be administered to verify the dosage, the method and duration of administration, or contraindications. It is the responsibility of the treating physician or other healthcare professionals, relying on independent experience and knowledge of the patient, to determine drug dosages and the best treatment for the patient.
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Foot and Ankle Quarterly (FAQ) is a unique program designed to help today’s podiatric physician manage an ever-increasing flow of information. After completing the Foot and Ankle Quarterly, Volume 31 program, the learner should be better able to: develop and refine a perspective on current treatment recommendations, updates, and advances pertinent to podiatric practice; evaluate the implications of the learned information as it pertains to the diagnosis and treatment of podiatric disorders and societal issues and barriers, and; apply current trends, standards, and best practices into learner’s own practice.
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Article Authors and Lecturers Duane J. Ehredt Jr., DPM (n.)
Warren Joseph, DPM (n.)
Annette Joyce, DPM (n.)
James B. McGuire, PT, DPM (n.)
Robert G. Smith, DPM, MSc, RPh (1. Data Trace Publishing Company)
Robert G. Smith, DPM, MSc, RPh
Private Practice, Shoe String Podiatry, Ormond Beach, FL; Clinical Pharmacist, Select Medical Hospital, Daytona Beach, FL; Assistant Clinical Professor in Podiatry, College of Podiatric Medicine, Western University of Health Sciences, Pomona, CA; Consultant, National Board of Podiatric Medical Examiners; Certified Pedorthist; Certified Pharmacy Regulatory Specialist
Contributors
Duane J. Ehredt Jr., DPM
Associate Professor, Division of Foot and Ankle Surgery and Biomechanics, Kent State University College of Podiatric Medicine, Independence, OH; Podiatric Surgeon, Saint Vincent Medical Group, Saint Vincent Charity Medical Center, Cleveland, OH; Fellow, American College of Foot and Ankle Surgeons
Warren Joseph, DPM Private Practice, Hatboro, PA; Adjunct Clinical Professor, Arizona School of Podiatric Medicine, Midwestern University, Glendale, AZ
Annette Joyce, DPM
Private practice, Pawleys Island, SC; Meeting Chair, Scientific Advisory Board, Dermfoot Medical Conference, Tysons, VA
James B. McGuire, PT, DPM Clinical Professor, Departments of Podiatric Medicine and Biomechanics, Temple University School of Podiatric Medicine; Director, Leonard Abrams Center for Advanced Wound Healing, Temple University School of Podiatric Medicine’s Foot and Ankle Institute; Staff Member, Temple University Hospital, Philadelphia, PA; Fellow, Academy of Physicians in Wound Healing; Licensed Pedorthist.
In This Issue:
FEATURE ARTICLE: A Prescription for Veneni dextera dextrae Tempus: A Clinical Pharmacology Update
Robert G. Smith, DPM, MSc, RPh
CONDENSATIONS and COMMENTARIES
Pharmacogenomics
Commentary by Robert G. Smith, DPM, MSc, RPh
Principles and Practice of Antibiotic Stewardship in the Management of Diabetic Foot Infections
Commentary by Warren Joseph, DPM
Venous Thromboembolism and Bleeding Adverse Events in Lower Leg, Ankle and Foot Orthopaedic Surgery with and without Anticoagulants 87
Commentary by Duane J. Ehredt Jr., DPM
Safety of Dermatologic Medications in Pregnancy and Lactation: Part I 90
Commentary by Robert G. Smith, DPM, MSc, RPh
The Implications of Biologic Therapy for Elective Foot and Ankle Surgery in Patients with Rheumatoid Arthritis 93
Commentary by Robert G. Smith, DPM, MSc, RPh
Cannabinoids: Current and Future Options to Treat Chronic and Chemotherapy-Induced Neuropathic Pain 96
Commentary by Robert G. Smith, DPM, MSc, RPh
Evaluation and Peri-Operative Management of the Diabetic Patient 100
Commentary by Robert G. Smith, DPM, MSc, RPh
Medicines Management Activity with Physiotherapy and Podiatry: A Systematic Mixed Studies Review 103
Commentary by James B. McGuire PT, DPM
Prevention of Infection in Foot and Ankle Surgery 106
Commentary by Robert G. Smith, DPM, MSc, RPh
Update on Current Approaches to Diagnosis and Treatment of Onychomycosis 109
Commentary by Annette Joyce, DPM
Morbidity, Mortality and Management of Methicillin-Resistant S.aureus Bacteremia in the USA: Update on Antibacterial Choices and Understanding 112
Commentary by Robert G. Smith, DPM, MSc, RPh
A Contemporary Medicolegal Analysis of Injury Related to Peripheral Nerve Blocks 116
Commentary by Robert G. Smith, DPM, MSc, RPh
Antimicrobial Stewardship Opportunities among Inpatients with Diabetic Foot Infections: Microbiology Results from a Tertiary Hospital Multidisciplinary Unit 119
Commentary by Warren Joseph, DPM
AUDIO LECTURE 1: Avoiding Drug Injury: Responsibilities of the Lower Extremity Physician 122
Robert G. Smith, DPM, MSc, RPh
AUDIO LECTURE 2: New Medications: Reshaping Treatment Options for the Lower Extremity Physician 124
Robert G. Smith, DPM, MSc, RPh
