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  • 1
    Online Resource
    Online Resource
    Factors Influencing Provider and Patient Choice of P2Y 12 Inhibitor Therapy
    SAGE Publications ; 2022
    In:  Journal of Pharmacy Practice Vol. 35, No. 2 ( 2022-04), p. 235-243
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 35, No. 2 ( 2022-04), p. 235-243
    Abstract: Clopidogrel is the most commonly prescribed P2Y 12 inhibitor for acute coronary syndrome (ACS) or stent placement, though ticagrelor or prasugrel may be preferred. Medication-related factors may influence selection of therapy. Objectives: To determine which factors most greatly influence cardiology-provider and patient selection of P2Y 12 inhibitor to guide shared-decision making (SDM). Methods: Single-center study assessed survey responses from 32 cardiology-providers who prescribed and 105 patients who received clopidogrel, prasugrel, or ticagrelor for ACS or stent placement. Respondents ranked factors influencing P2Y 12 inhibitor selection and reported preference of therapy. Patients reported experience with shared decision-making process. Results: Cardiology-providers ranked risk of bleeding, comfort/experience, and cost as most influential. Patients ranked risk of drug interaction, adverse effects, and reduction in myocardial infarction as most influential. Significant differences between cardiology-providers and patients were found for 5 of 8 factors. Cardiology-providers ranked once daily administration (p = 0.01), risk of bleeding (p = 0.002), and cost (p 〈 0.001) as more important than patients. Patients ranked risk of adverse effects (p = 0.007) and drug interactions (p = 0.005) as more important than cardiology-providers. Cardiology-providers prescribed ticagrelor 42.3% of the time following ACS, though 78.1% ranked it as their preferred agent. Patients were prescribed ticagrelor 9.3% of the time, though 55.7% ranked it as their preferred agent. Use of SDM was reported by 21.6% of patients and 88.5% were unaware that multiple P2Y 12 inhibitors existed. Conclusion: Significant differences exist between cardiology-providers and patients regarding factors influencing P2Y 12 inhibitor selection, specifically safety-related factors, once daily administration, and cost. Most patients were not involved in SDM.
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/0897190020966174
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2131091-9
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  • 2
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    The effect of repeated testing of pharmacy calculations and drug knowledge to improve knowledge retention in pharmacy students
    Elsevier BV ; 2018
    In:  Currents in Pharmacy Teaching and Learning Vol. 10, No. 12 ( 2018-12), p. 1609-1615
    Details
    In: Currents in Pharmacy Teaching and Learning, Elsevier BV, Vol. 10, No. 12 ( 2018-12), p. 1609-1615
    Type of Medium: Online Resource
    ISSN: 1877-1297
    URL: Article
    DOI: 10.1016/j.cptl.2018.08.019
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2515217-8
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  • 3
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    Aspirin Use for the Primary Prevention of Cardiovascular Disease in the Elderly
    American Society of Consultant Pharmacists ; 2016
    In:  The Consultant Pharmacist Vol. 31, No. 1 ( 2016-01-01), p. 24-32
    Details
    In: The Consultant Pharmacist, American Society of Consultant Pharmacists, Vol. 31, No. 1 ( 2016-01-01), p. 24-32
    Abstract: OBJECTIVE: This article aims to use the available evidence assessing aspirin for primary prevention of cardiovascular (CV) events in the elderly to determine its appropriate use. DATA SOURCES: A literature search of clinical trials and meta-analyses was conducted using MEDLINE and PubMed with the search terms aspirin, bleeding, CV events, elderly, geriatrics, hemorrhage, myocardial infarction (MI), primary prevention, and stroke. STUDY SELECTION/DATA EXTRACTION: Twelve hundred fourteen (1,214) articles were initially found, and 55 were reviewed. These articles assessed the use of aspirin for primary prevention of CV events. Only trials comparing aspirin with placebo, a non-antiplatelet, or a non-anticoagulant were included in this review. Of the articles reviewed, 10 met the stated criteria. DATA SYNTHESIS: It is well documented that the risk of CV events increases as patients age. Primary prevention of these events with aspirin may be beneficial in some patients. Currently, a specific recommendation for the use of aspirin for primary prevention in the geriatric population is not available. This paper reviews the available evidence for primary prevention of CV disease. This population is under-represented in the literature, making it challenging to apply the study findings. CONCLUSION: Aspirin may be considered for the primary prevention of CV events in the elderly population. Because of the lack of data in patients 80 years of age and older, it is difficult to make a decision on the initiation of aspirin therapy in this population. Additional research is necessary to better balance the risk versus benefit of this treatment option.
    Type of Medium: Online Resource
    ISSN: 0888-5109
    URL: Article
    DOI: 10.4140/TCP.n.2016.24
    Language: English
    Publisher: American Society of Consultant Pharmacists
    Publication Date: 2016
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  • 4
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    Comparison of sustained rate control in atrial fibrillation with rapid ventricular rate: Metoprolol vs. Diltiazem
    Elsevier BV ; 2021
    In:  The American Journal of Emergency Medicine Vol. 40 ( 2021-02), p. 15-19
    Details
    In: The American Journal of Emergency Medicine, Elsevier BV, Vol. 40 ( 2021-02), p. 15-19
    Type of Medium: Online Resource
    ISSN: 0735-6757
    URL: Article
    DOI: 10.1016/j.ajem.2020.11.073
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2041648-9
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  • 5
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    Effect of Therapeutic Interchange on Medication Changes Between Admission and Discharge
    SAGE Publications ; 2020
    In:  Hospital Pharmacy Vol. 55, No. 6 ( 2020-12), p. 382-390
    Details
    In: Hospital Pharmacy, SAGE Publications, Vol. 55, No. 6 ( 2020-12), p. 382-390
    Abstract: Background: Therapeutic interchange (TI) is the dispensing of an alternative medication within the same class as the original medication. TI often occurs in hospitals; however, failure to return patients to their original medications may increase the risk of adverse effects following hospital discharge. Objective: The purpose of this study was to evaluate the relationship between TI and discharge medication changes, hospital readmission rates, and emergency department visit rates following hospital discharge. Methods: Patient demographic and medication data were collected retrospectively for patients admitted to a nonprofit, acute care hospital. The primary outcome was the relationship between TI and the rate of discharge medication changes. Secondary outcomes included types of discharge medication changes and the relationship between TI and both hospital readmissions and emergency department visits following hospital discharge. Results: A total of 497 patients accounting for 1072 medications were included; 21.2% of home medications were interchanged following admission, and 21.8% of home medications were changed at discharge. TI increased the incidence of discharge medication changes by 70% (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 1.22-2.37, P = .0021). Cardiovascular agents were most likely to be changed at discharge (26%), and gastrointestinal agents were most likely to be interchanged (65%). Psychotropic agents were least likely to be changed at discharge (12%) or interchanged (7%). Neither TI nor discharge medication changes were predictive of 30-, 60-, or 90-day hospital readmission or emergency department visits following discharge. Conclusion and Relevance: This study was the first to examine the effects of TI on post-discharge outcomes. Despite being associated with an increased rate of discharge medication changes, the presence of TI did not correlate with hospital readmission or emergency department visit rates. This study supports the safety of TI.
    Type of Medium: Online Resource
    ISSN: 0018-5787 , 1945-1253
    URL: Article
    DOI: 10.1177/0018578719848733
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2069227-4
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  • 6
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    The Role of Cefepime in the Treatment of Extended-Spectrum Beta-Lactamase Infections
    SAGE Publications ; 2019
    In:  Journal of Pharmacy Practice Vol. 32, No. 4 ( 2019-08), p. 458-463
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 32, No. 4 ( 2019-08), p. 458-463
    Abstract: To review the efficacy of cefepime for use in infections caused by extended-spectrum beta-lactamase (ESBL)-producing organisms. Data Sources: A PubMed literature search (May 2000 to June 2017) was performed using the keyword cefepime and the MeSH terms beta-lactamases, cephalosporinases, and Enterobacteriaceae infections. Study Selection and Data Extraction: All human, English language studies evaluating cefepime use for the treatment of ESBL-producing Escherichia coli and Klebsiella pneumoniae infections were included. Data Synthesis: Studies assessing the use of cefepime for ESBL infections are few, and clinical studies are limited by design and sample size. The largest pharmacokinetic/pharmacodynamic study, a Monte Carlo simulation using data from the U.S. SENTRY antimicrobial surveillance program, evaluating cefepime use for infections due to ESBL-producing organisms found a 95% to 100% probability of target attainment with traditional cefepime dosing regimens. Most clinical studies found that patients treated with cefepime empirically and definitively had higher rates of mortality than those treated with carbapenems. However, in concordance with other studies reporting minimum inhibitory concentration (MIC) data, lower MICs were associated with lower mortality. Conclusions: Cefepime should be avoided for empiric treatment of suspected ESBL infections and should only be considered for definitive treatment if the MIC ≤1 µg/mL. However, the site and severity of infection, local resistance patterns, and patient-specific risk factors should also help guide antimicrobial selection.
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/0897190017743134
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2131091-9
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  • 7
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    A clinical focus on the use of extended-duration thromboprophylaxis in medically ill patients
    Oxford University Press (OUP) ; 2021
    In:  American Journal of Health-System Pharmacy Vol. 78, No. 12 ( 2021-06-07), p. 1057-1065
    Details
    In: American Journal of Health-System Pharmacy, Oxford University Press (OUP), Vol. 78, No. 12 ( 2021-06-07), p. 1057-1065
    Abstract: This review describes and analyzes literature to provide recommendations for use of extended-duration thromboprophylaxis (EDT) in medically ill patients. Summary Guidelines recommend pharmacologic thromboprophylaxis for patients at increased thrombosis risk during hospitalization and recommend against extending thromboprophylaxis beyond hospitalization. Despite these recommendations, observational data demonstrate that venous thromboembolism (VTE) risk persists following hospital discharge. A MEDLINE literature search was performed to identify original research evaluating the safety and efficacy of EDT. Eight meta-analyses and 5 randomized controlled trials—each varying in the agents studied (enoxaparin, rivaroxaban, apixaban, and betrixaban)—were selected for inclusion. Collectively, the evaluated data demonstrates that EDT reduces the incidence of VTE at the expense of increasing the risk of major bleeding and without providing mortality reduction. Variations in enrollment criteria, differences in EDT strategies, and uncertainty regarding proper patient selection limit the applicability of EDT in practice. Rivaroxaban and betrixaban gained Food and Drug Administration (FDA) approval on the basis of results of the APEX and MARINER trials and a post hoc analysis of the MAGELLEN trial results. Although a number of agents are FDA approved for use in EDT, clinicians must carefully weigh the risks vs benefits of EDT with these agents until studies demonstrate a more favorable risk-benefit profile. Conclusion Evidence to support EDT in medically ill patients is inconclusive and has highlighted the need for an individualized approach. The reviewed evidence supports guideline recommendations from both the American College of Chest Physicians and the American Society of Hematology that recommend against routine use of EDT in the majority of medically ill patients. Future studies are needed to optimize the risk-benefit profile of EDT and to ensure proper patient selection.
    Type of Medium: Online Resource
    ISSN: 1079-2082 , 1535-2900
    URL: Article
    DOI: 10.1093/ajhp/zxab039
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 8
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    The role of SGLT2 inhibitors in heart failure
    Scientific Scholar ; 2022
    In:  American Journal of Pharmacotherapy and Pharmaceutical Sciences Vol. 1 ( 2022-01-20), p. 2-
    Details
    In: American Journal of Pharmacotherapy and Pharmaceutical Sciences, Scientific Scholar, Vol. 1 ( 2022-01-20), p. 2-
    Abstract: Heart failure (HF) is a highly prevalent disease worldwide. Its prevalence is expected to grow for the foreseeable future increasing the need for continuous assessment and optimization of guideline-directed medical therapy. The purpose of this article is to review available data assessing the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors for management of HF. An independent literature search using PubMed was performed by each author to identify all pertinent articles. In addition, reference sections of each article were reviewed. Articles were eligible for inclusion if they assessed the use of SGLT2 inhibitors on therapeutic outcomes related to HF. Among patients with HF, SGLT2 inhibitors reduced the risk of cardiovascular mortality and HF hospitalization regardless of the presence of diabetes. These agents increased the risk of urinary and genital infections. These data support the addition of SGLT2 inhibitors to guideline-directed medical therapy in HF patients, especially those with a reduced ejection fraction.
    Type of Medium: Online Resource
    ISSN: 2835-253X , 2836-2012
    URL: Journal
    URL: Article
    DOI: 10.25259/AJPPS
    DOI: 10.25259/AJPPS_5_2021
    Language: English
    Publisher: Scientific Scholar
    Publication Date: 2022
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  • 9
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    Management of Direct-Acting Oral Anticoagulants Surrounding Dental Procedures With Low-to-Moderate Risk of Bleeding
    SAGE Publications ; 2018
    In:  Journal of Pharmacy Practice Vol. 31, No. 2 ( 2018-04), p. 202-207
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 31, No. 2 ( 2018-04), p. 202-207
    Abstract: The purpose of this article is to review the available evidence regarding how to safely manage direct-acting oral anticoagulant (DOAC) therapy in patients requiring dental procedures with low-to-moderate risk of bleeding. A literature search was performed using MEDLINE and PubMed. Each author performed an independent search to ensure all pertinent articles were identified. The reference sections of each article were also reviewed. Pertinent articles were evaluated by each author for inclusion. Articles were eligible for inclusion if the participants were taking DOAC therapy surrounding a dental procedure known to have low-to-moderate risk of bleeding. Studies could be prospective or retrospective and included case reports, case series, and clinical trials. Articles were excluded if they assessed dental procedures known to carry a high risk of bleeding or were review articles. Twenty-five articles were identified, 5 of which met inclusion criteria including 2 case series, 1 retrospective study, and 2 prospective trials. Variation in the management of DOAC therapy surrounding these procedures was found. Among patients undergoing low-to-moderate risk dental procedures while receiving DOAC therapy, bleeding rates were low regardless of whether the DOAC was held or continued surrounding the procedure. Documented bleeding was mild and easily controlled by local hemostatic measures. Patients can safely continue DOAC therapy surrounding these dental procedures.
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/0897190017707126
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2131091-9
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  • 10
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    Effect of Nonselective β-Blockers on Mortality in Patients With End-Stage Cirrhosis
    SAGE Publications ; 2020
    In:  Annals of Pharmacotherapy Vol. 54, No. 4 ( 2020-04), p. 322-330
    Details
    In: Annals of Pharmacotherapy, SAGE Publications, Vol. 54, No. 4 ( 2020-04), p. 322-330
    Abstract: Background: Data regarding safety of nonselective β-blockers (NSBBs) in patients with end-stage cirrhosis are conflicting, making it difficult for practitioners to justify if benefits outweigh the risks. Objective: Evaluate the effect of NSBB use on mortality in patients with end-stage cirrhosis. Methods: We performed a dual-center retrospective study of patients who received octreotide for a variceal bleed. Patients were stratified into 2 groups based on whether or not a NSBB was prescribed at hospital discharge. The primary outcome was 24-month mortality. Multivariable logistic regression, with 24-month mortality as the dependent variable, was performed to identify independent risk factors for the primary outcome. Results: 255 patients met inclusion criteria; 24-month mortality was 32.8%. The NSBB and no-NSBB groups had similar mortality rates at 24 months (32.0% vs 38.5%, P = 0.51). Mortality at 3 months (11.6% vs 23.3%, P = 0.08) and 12 months (22.2% vs 30.0%, P = 0.36) were similar, and there were no differences in rate of variceal bleeding (22.7% vs 13.3%, P = 0.34) or cirrhosis-related cause of death (20.4% vs 23.3%, P = 0.81). In the multivariable model, age, model for end-stage liver disease with sodium and hepatocellular carcinoma were independent risk factors for 24-month mortality. NSBB therapy had no effect on 24-month mortality (adjusted odds ratio = 1.05; 95% CI = 0.32 to 3.40). Conclusion and Relevance: In patients with end-stage cirrhosis, use of NSBBs did not affect 24-month mortality. More research is needed to determine when, and if, NSBBs should be discontinued in end-stage cirrhosis.
    Type of Medium: Online Resource
    ISSN: 1060-0280 , 1542-6270
    URL: Article
    DOI: 10.1177/1060028019886529
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2053518-1
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