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In the cardio-oncology population, drug interactions are of particular importance given the complex pharmacological profile, narrow therapeutic index, and inherent risk of therapies used to manage cardiovascular disease and cancer. Drug interactions may be beneficial or detrimental to the desired therapeutic effect. Clinicians in both cardiology and oncology should be cognizant of these potential drug-drug interactions that may reduce the efficacy or safety of either cardiovascular or cancer therapies. These risks can be mitigated through increased recognition of potential drug-drug interaction, use of alternative medications when possible, and careful monitoring. This scientific statement provides clinicians with an overview of pharmacodynamic and pharmacokinetic drug-drug interactions in patients with cancer exposed to common cardiovascular and cancer medications.

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Clinical pharmacists are highly trained professionals who provide comprehensive medication management across a majority of health care settings. These clinicians have numerous responsibilities, which may include teaching, administrative, and scholarly responsibilities in addition to patient care activities. Many clinical pharmacists report a high degree of burnout and stress. In addition, practice models with limited options for buy-downs or stipends (eg, for committees, projects, or residency program director roles), inability to generate revenue for services provided, public perception, and little upward mobility for career advancement have led to a perceived trend of clinical pharmacists leaving practice to pursue careers removed from patient care that favor work-life balance. The purpose of this review is to summarize factors associated with premature attrition of clinical pharmacists, call attention to this trend, and provide suggestions for improvements.

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