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Pharmacotherapy

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https://www.readbyqxmd.com/read/29337395/testosterone-suppression-with-luteinizing-hormone-releasing-hormone-lhrh-agonists-in-patients-receiving-radiotherapy-for-prostate-cancer
#1
Derek Wilke, Nikhilesh Patil, Helmut Hollenhorst, David Bowes, Robert Rutledge, Casely Ago
OBJECTIVES: To characterize the probability of testosterone escape during a course of radiotherapy and androgen deprivation (ADT) in patients with prostate cancer, and examine predictors of testosterone escape, the prostate specific antigen (PSA) levels during testosterone escape, and the impact of testosterone escape on outcome. PATIENTS AND METHODS: To participate in the database review, necessary data included: (i) type of luteinizing hormone-releasing hormone agonist (LHRHa) administered, date of initiation, and date of cessation or duration of therapy, (ii) radiotherapy information (start date and dose) with at least 6 months of follow-up after radiotherapy, (iii) had to have radiotherapy to the prostate or prostate bed, and (iv) had to have a least one serum testosterone and PSA measurement...
January 16, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29331037/pharmacist-intervention-for-blood-pressure-control-in-patients-with-diabetes-and-or-chronic-kidney-disease
#2
Maxwell D Anderegg, Tyler H Gums, Liz Uribe, Eric J MacLaughlin, James Hoehns, Oralia V Bazaldua, Timothy J Ives, David L Hahn, Christopher S Coffey, Barry L Carter
OBJECTIVES: The objectives of this study were to 1) determine if hypertensive patients with comorbid diabetes mellitus (DM) and/or chronic kidney disease (CKD) receiving a pharmacist intervention had a greater reduction in mean blood pressure (BP) and improved BP control at 9 months compared to those receiving usual care and 2) compare Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) guideline and 2014 guideline (JNC-8) BP control rates in patients with DM and/or CKD...
January 13, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29328496/hypotension-risk-based-on-vasoactive-agent-discontinuation-order-in-patients-in-the-recovery-phase-of-septic-shock
#3
Gretchen L Sacha, Simon W Lam, Abhijit Duggal, Heather Torbic, Anita J Reddy, Seth R Bauer
STUDY OBJECTIVES: Patients with septic shock often require vasoactive agents for hemodynamic support; however, the optimal approach to discontinuing these agents once patients reach the recovery phase is currently unknown. The objective of this evaluation was to compare the incidence of hypotension within 24 hours based on the discontinuation order of norepinephrine (NE) and vasopressin (AVP) in patients in the recovery phase of septic shock. DESIGN: Retrospective cohort study...
January 12, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29315727/considerations-for-optimal-blood-pressure-goals-in-the-elderly-population-a-review-of-emergent-evidence
#4
Diana X Cao, Rebecca J C Tran
Recent hypertension clinical trials and national guideline updates have created a debate on the most appropriate treatment goals in elderly patients with hypertension. In 2014, recommendations by the Eighth Joint National Committee (JNC 8) allowed a more lenient goal for patients 60 years and older compared with previous guidelines. Since then, several large clinical trials and meta-analyses have added more information regarding strict versus lenient treatment goals. Most recently, the American College of Cardiology and American Heart Association Task Force published their highly-anticipated hypertension guideline developed in conjunction with nine additional interdisciplinary organizations...
January 8, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29286546/serious-liver-injury-associated-with-macitentan-a-case-report
#5
Thao T Tran, Allen D Brinker, Monica Muñoz
Several endothelin receptor antagonists (ERAs) that were developed for the treatment of pulmonary arterial hypertension (PAH), including bosentan and sitaxentan, have been linked to clinically significant hepatocellular injury, as well as liver failure. We describe the first case of fulminant hepatitis to be reported in association with the ERA macitentan. This case was recently identified within the United States Food and Drug Administration Adverse Event Reporting System (FAERS) and and describes liver transplantation occuring 13 months following macitentan initiation in a young patient (23-years old) with idiopathic PAH New York Heart Association (NYHA) functional class III...
December 29, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29286545/one-year-effectiveness-study-of-intravitreous-ranibizumab-in-neovascular-age-related-macular-degeneration-a-meta-analysis
#6
Michael Guo, Mahyar Etminan, Jasmine Cheng, Zafar Zafari, David Maberley
PURPOSE: The clinical efficacy of ranibizumab has been examined by a large number of prospective and retrospective studies to date. This meta-analysis was conducted to summarize the current body of evidence on visual acuity (VA) changes with use of ranibizumab in the treatment of neovascular age-related macular degeneration (wAMD). METHODS: A literature review of multiple electronic databases (EMBASE, MEDLINE, MedMEME) was conducted to find randomized controlled trials (RCTs) and observational studies that reported changes in VA while patients with wAMD were on ranibizumab...
December 29, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29286540/facilitators-and-barriers-to-the-adoption-of-pharmacogenetic-testing-in-an-inner-city-population
#7
Yee Ming Lee, Beenish S Manzoor, Larisa H Cavallari, Edith A Nutescu
OBJECTIVES: To examine the knowledge, attitudes, and interest of an inner city population toward pharmacogenetic testing, with the primary objective of identifying facilitators and barriers toward pharmacogenetic testing; and secondary objectives of determining predictors of patient interest in pharmacogenetic testing and how much patients would pay for the test. METHODS: Patients were recruited from an Antithrombosis Clinic from March to April 2014. A cross-sectional 19-question survey was administered in-person to determine patients' knowledge and awareness of pharmacogenetic testing and collect demographic information...
December 29, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29283440/cabozantinib-a-multi-targeted-oral-tyrosine-kinase-inhibitor
#8
Jordan N Markowitz, Karen M Fancher
Cabozantinib is an oral, small-molecule, multitargeted tyrosine kinase inhibitor (TKI) that may confer an advantage over other TKIs that target a single receptor. It has been approved by the United States Food and Drug Administration for the treatment of both advanced renal cell carcinoma and progressive metastatic medullary thyroid cancer, and is being investigated for a wide array of other malignancies. Rationale for use, clinical trial data, and current recommendations for cabozantinib in renal cell cancer, thyroid cancer, prostate cancer, hepatocellular cancer, and lung cancer are detailed in this article...
December 28, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29266309/evolving-role-of-non-statin-therapy-for-the-management-of-dyslipidemia-and-cardiovascular-risk-reduction-past-present-and-future
#9
Evan M Sisson, Lauren Pamulapati, John D Bucheit, Michael S Kelly, Dave L Dixon
A plethora of evidence supports the use of statin therapy for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD), yet residual risk among high-risk patients receiving statin therapy remains high. Moreover, statin-associated muscle symptoms and other statin-associated adverse effects (e.g., increased risk of diabetes mellitus) limit the use of statins in high-risk patient populations. Of particular concern are individuals with established ASCVD, familial hypercholesterolemia (FH), or diabetes mellitus plus multiple ASCVD risk factors, all of whom require high-intensity statins, which are more commonly associated with an increased risk of adverse effects...
December 19, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29265423/paradigm-hf-trial-secondary-analyses-address-unanswered-questions
#10
Kristin R Smith, Chia-Chi Hsu, Theodore J Berei, Ahmed Aldemerdash, Ian B Hollis, Orly Vardeny, Jo Ellen Rodgers
OBJECTIVES: To summarize published secondary analyses of the PARADIGM-HF trial. In the original trial, published in September 2014, sacubitril/valsartan significantly reduced the primary composite outcome of cardiovascular death or heart failure hospitalization compared to enalapril. This summary provides a resource for clinicians to review subsequent analyses of the landmark trial evaluating the benefit of sacubitril/valsartan in various subgroups and providing information regarding optimal use with this new therapy in the broader heart failure population...
December 19, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29250815/current-and-emerging-pharmacotherapies-for-cessation-of-tobacco-smoking
#11
Nieves Gómez-Coronado, Adam J Walker, Michael Berk, Seetal Dodd
Tobacco use disorder is a chronic illness. With its high comorbidity rate, it is a major cause of years of life lost or years lived with disability; however, is also considered the most preventable cause of death in developed countries. Since the development of nicotine replacement therapy (NRT) in 1978, treatment options have continued to evolve and expand. Despite this, currently available treatments remain insufficient, with less than 25% of smokers remaining abstinent after one year after treatment. In this article, we review existing and emerging smoking cessation pharmacotherapies, affording a special emphasis on the most promising agents that are currently being investigated...
December 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29245184/evaluation-of-the-use-of-novel-biomarkers-to-augment-antimicrobial-stewardship-program-activities
#12
Kayla R Stover, Rachel M Kenney, Travis S King, Alan E Gross
As antimicrobial stewardship increasingly receives worldwide attention for improving patient care by optimizing antimicrobial therapy, programs are evaluating new tools that may augment antimicrobial stewardship activities. Biomarkers are objective, accurate, and reproducible measures that provide information about medical conditions. A systematic literature search using PubMed/MEDLINE databases was performed to evaluate the use of novel biomarkers as additions to the antimicrobial stewardship armamentarium...
December 15, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29239004/providing-comprehensive-medication-management-in-telehealth
#13
Melissa E Badowski, Scot Walker, Shaffeeulah Bacchus, Sandy Bartlett, Juliana Chan, Kelly A Cochran, Scott Coon, Michelle Liedtke, Brad Phillips, Taylor White
The goal of this white paper is to provide direction for clinical pharmacists providing telehealth. Telehealth care is rapidly emerging to improve patient access to health care and optimize patient health outcomes. With the increasing ability to access electronic health record portals, as many as 75 million telehealth encounters are expected in North America annually. Although electronic "point of access" undoubtedly increases the use of medical and pharmacy services, the real value of telehealth lies in improved access to patients in remote areas lacking adequate medical and pharmacy services and to high-risk patients requiring frequent monitoring...
December 14, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29236288/disaster-preparedness-biological-threats-and-treatment-options
#14
Navaneeth Narayanan, Clifton R Lacy, Joseph E Cruz, Meghan Nahass, Jonathan Karp, Joseph A Barone, Evelyn Hermes-DeSantis
Biological disasters can be natural, accidental, or intentional. Biological threats have made a lasting impact on civilization. This review will focus on agents of clinical significance, bioterrorism, and national security; specifically Category A agents (anthrax, botulism, plague, tularemia, and smallpox), as well as briefly discuss other naturally-emerging infections of public health significance including Ebola virus (also a Category A agent) and Zika virus. The role of the pharmacist in disaster preparedness and disaster response is multifaceted and important...
December 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29235661/association-of-higher-daptomycin-dose-%C3%A2-7-mg-kg-with-improved-survival-in-patients-with-methicillin-resistant-staphylococcus-aureus-bacteremia
#15
Tristan T Timbrook, Aisling R Caffrey, Megan K Luther, Vrishali Lopes, Kerry L LaPlante
STUDY OBJECTIVE: Current guidelines recommend higher daptomycin doses than the daptomycin label dose of 6 mg/kg for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, the evidence supporting this recommendation is from in vitro and cases series studies. The objective of this study was to evaluate the comparative effectiveness of the daptomycin label dose versus higher daptomycin doses in patients with MRSA bacteremia. DESIGN: Retrospective national cohort study...
December 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29197117/addition-of-allopurinol-for-altering-thiopurine-metabolism-to-optimize-therapy-in-patients-with-inflammatory-bowel-disease
#16
Geoffrey C Wall, Hamid Muktar, Cassandra Effken, Pramod B Mahajan
Thiopurine drugs, including azathioprine and 6-mercaptopurine, are used commonly in patients with inflammatory bowel disease for maintenance of remission. Although generally well tolerated, adverse effects lead to discontinuation in a significant minority of patients. Pharmacogenomic studies have suggested that metabolic breakdown of azathioprine in an individual is genetically determined. Coupled with the fact that certain thiopurine metabolites, notably 6-thioguanine nucleotide and 6-methylmercaptopurine, are associated with antiinflammatory effects and adverse effects, respectively, some investigators have examined intentionally shunting the metabolism of azathioprine toward increasing 6-thioguanine nucleotide levels by using low doses of the xanthine oxidoreductase inhibitor allopurinol to improve efficacy and decrease toxicity of azathioprine in patients with inflammatory bowel disease...
December 1, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29197108/refining-a-claims-based-algorithm-to-estimate-biologic-medication-effectiveness-and-cost-per-effectively-treated-patient-with-rheumatoid-arthritis
#17
Ryan A Popp, Karen Rascati, Matthew Davis, Ujas Patel
BACKGROUND: Claims data generally lack information on clinical outcomes. However, a validated, claims-based algorithm for estimating effectiveness of biologic agents in treating rheumatoid arthritis (RA) has recently been developed and applied to various databases. OBJECTIVES: The objectives of the study were to implement a claims-based algorithm in a large nationwide database to estimate medication effectiveness and cost for patients with RA using biologic disease-modifying antirheumatic drugs (DMARDs) and to assess the effect of eliminating one criterion from the algorithm on results...
December 1, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29193185/ketamine-infusion-for-adjunct-sedation-in-mechanically-ventilated-adults
#18
Lara M Groetzinger, Ryan M Rivosecchi, William Bain, Marshall Bahr, Katherine Chin, Ian Barbash, Bryan J McVerry
BACKGROUND: Many critically ill patients receive ketamine for adjunct sedation despite a paucity of evidence on its usage, dosing, and monitoring in this setting. OBJECTIVE: To describe the dosing and safety considerations of ketamine for adjunct sedation in a population of mechanically ventilated critically ill patients targeting light sedation. METHODS: We conducted a retrospective review of mechanically ventilated patients receiving continuous ketamine infusion between January 2012 and April 2016...
November 29, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29160945/lacosamide-pharmacokinetics-in-a-critically-ill-patient-receiving-continuous-venovenous-hemofiltration
#19
Miguel J Franquiz, Shamir N Kalaria, Michael J Armahizer, Mathangi Gopalakrishnan, Paul J McCarthy, Neeraj Badjatia
OBJECTIVE: Lacosamide is a new generation antiepileptic drug (AED) that is eliminated by both hepatic and renal mechanisms. Lacosamide elimination by Continuous Renal Replacement Therapy (CRRT) has never been studied. The objective of this case report was to describe lacosamide pharmacokinetics in the setting of CRRT. METHODS: Case report of a single patient admitted to the study center with status epilepticus and multi-organ failure. The patient required both continuous venovenous hemofiltration (CVVH) and several AEDs...
November 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29155443/the-philosophy-of-practice-for-comprehensive-medication-management-evaluating-its-meaning-and-application-by-practitioners
#20
Deborah L Pestka, Lindsay A Sorge, Mary Roth McClurg, Todd D Sorensen
OBJECTIVE: Philosophy of practice is the foundation to any patient care practice as it provides a set of professional values and beliefs that guide actions and decisions in practice. Study objectives were to understand how pharmacists providing comprehensive medication management (CMM) describe their philosophy of practice and compare how participants' philosophies align with predefined tenets of a CMM philosophy of practice. METHODS: An instrument with closed and open-ended items was developed and administered online to the lead pharmacist at 36 clinics participating in a large CMM study...
November 20, 2017: Pharmacotherapy
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