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Pharmacotherapy

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https://www.readbyqxmd.com/read/28079270/treatment-of-adults-with-idiopathic-recurrent-pericarditis-novel-use-of-immunotherapy
#1
Nicholas C Schwier, Genevieve Hale, Marie L Davies
Idiopathic recurrent pericarditis (IRP) can be challenging to treat. Even after guideline-directed, first-line treatment consisting of aspirin (ASA) or a nonsteroidal antiinflammatory drug (NSAID) in combination with colchicine therapy, recurrences still occur in greater than 20% of patients. Many patients then require treatment with long-term corticosteroids, which is not a favorable option due to their short- and long-term adverse effects. Since it is theorized that the pathophysiology of IRP may possess autoimmune sequelae, the use of immunotherapy for the treatment of IRP has emerged...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28079266/risk-of-mortality-in-elderly-nursing-home-patients-with-depression-using-paroxetine
#2
Vishal Bali, Satabdi Chatterjee, Michael L Johnson, Hua Chen, Ryan M Carnahan, Rajender R Aparasu
OBJECTIVE: Among selective serotonin reuptake inhibitors (SSRIs), paroxetine is strongly anticholinergic and might lead to higher risk of adverse outcomes such as mortality. This study examined the risk of mortality in depressed elderly nursing home patients using paroxetine and other SSRIs. METHODS: This study used 2007-2010 Minimum Data Set - linked Medicare data and propensity score-matched retrospective cohort study design to achieve the study objective. New users of paroxetine and other SSRIs were followed until they reached the end of the follow-up period (one year), switched to a different antidepressant class, used psychotherapy, or had a gap of more than 15 days in the use of index antidepressant class, whichever occurred earlier...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28079265/chimeric-antigen-receptor-t-cells-in-hematologic-malignancies
#3
Brandon R Shank, Bryan Do, Adrienne Sevin, Sheree E Chen, Sattva S Neelapu, Sandra B Horowitz
Patients with B cell hematologic malignancies who progress through first or second line chemotherapy have a poor prognosis. Early clinical trials with autologous anti-CD19 chimeric antigen receptor (CAR) T cells have demonstrated promising results for patients who have relapsed or refractory disease. Lymphodepleting conditioning regimens including cyclophosphamide, fludarabine, pentostatin, bendamustine, interleukin-2, and total body irradiation are often administered prior to infusion of CAR T cells, allowing for greater T cell expansion...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28079263/comparison-of-rates-of-nephrotoxicity-associated-with-vancomycin-in-combination-with-piperacillin-tazobactam-administered-as-an-extended-versus-standard-infusion
#4
Mariam Mousavi, Tanya Zapolskaya, Marco R Scipione, Eddie Louie, John Papadopoulos, Yanina Dubrovskaya
STUDY OBJECTIVE: Despite recent reports of relatively high rates (16-37%) of acute kidney injury (AKI) in patients receiving the combination of intravenous piperacillin-tazobactam (PTZ) and vancomycin, data are limited evaluating the impact of PTZ infusion strategy on the occurrence of nephrotoxicity. The objective of this study was to compare the rates of nephrotoxicity in patients receiving vancomycin in combination with PTZ administered as an extended infusion (EI) versus a standard infusion (SI)...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28079262/pediatric-obesity-pharmacokinetic-alterations-and-effects-on-antimicrobial-dosing
#5
Stephanie Natale, John Bradley, William Huy Nguyen, Tri Tran, Pamela Ny, Kirsten La, Eva Vivian, Jennifer Le
BACKGROUND: Limited data exist for appropriate drug dosing in obese children. This comprehensive review summarizes pharmacokinetic alterations that occur with age and obesity, and these effects on antimicrobial dosing. A thorough comparison of different measures of body weight and specific antimicrobial agents, including cefazolin, cefepime, ceftazidime, daptomycin, doripenem, gentamicin, linezolid, meropenem, piperacill-tazobactam, tobramycin, vancomycin, and voriconazole, are presented...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28052412/identifying-potentially-avoidable-readmissions-a-medication-based-15-day-readmission-risk-stratification-algorithm
#6
Sreemanee Raaj Dorajoo, Vincent See, Chen Teng Chan, Joyce Zhenyin Tan, Doreen Su Yin Tan, Siti Maryam Binte Abdul Razak, Ting Ting Ong, Narendran Koomanan, Chun Wei Yap, Alexandre Chan
BACKGROUND: Stratifying patients according to 15-day readmission risk would be useful in identifying those who may benefit from targeted interventions during and/or following hospital discharge that are designed to reduce the likelihood of readmission. METHODS: A prediction model was derived via a case-control analysis of patients discharged from a tertiary hospital in Singapore using multivariate logistic regression. The model was validated in two independent external cohorts separated temporally and geographically...
January 4, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28052357/perioperative-inotrope-therapy-and-atrial-fibrillation-following-coronary-artery-bypass-graft-surgery-evidence-of-a-racial-disparity
#7
Jimmy T Efird, Andy C Kiser, Patricia B Crane, Hope Landrine, Linda C Kindell, Margaret-Ann Nelson, Charulata Jindal, Daniel F Sarpong, William F Griffin, T Bruce Ferguson, W Randolph Chitwood, Stephen W Davies, Alan P Kypson, Preeti Gudimella, Ethan J Anderson
BACKGROUND AND OBJECTIVE: Following coronary artery bypass graft (CABG) surgery, mortality rates are significantly higher among black patients who experience postoperative atrial fibrillation (POAF). Perioperative inotropic therapy (PINOT) has been shown to be associated with POAF in previous reports, but the extent to which race influences this association is unknown. In the present study, the relationship between PINOT, race, and POAF was examined in patients undergoing CABG surgery...
January 4, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28052356/an-overview-of-the-changing-landscape-of-treatment-for-advanced-melanoma
#8
Chung-Shien Lee, Christan M Thomas, Kimberly E Ng
Melanoma-the deadliest form of skin cancer-leads to thousands of deaths each year. Although melanoma is less common than basal cell and squamous cell skin cancers, melanoma is more dangerous because it is more likely to spread to other parts of the body, such as lymph nodes, if not diagnosed and treated early. Data from the National Cancer Institute indicate a steady rise in new cases of melanoma and, unfortunately, a steady rate in the number of deaths through 2013. Ninety percent of melanomas are linked to inadequate sun protection from ultraviolet rays or the tanning habits of young adults...
January 4, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28052354/evaluation-of-long-term-chronic-myeloid-leukemia-treatment-practices-with-tyrosine-kinase-inhibitors-in-a-national-cohort-of-veterans
#9
Eugene D Kreys, Christopher R Frei, Sarah M Villarreal, Mary J Bollinger, Xavier Jones, Jim M Koeller
STUDY OBJECTIVE: To evaluate nationwide chronic myeloid leukemia treatment practices over an extended period and across multiple lines of tyrosine kinase inhibitor (TKI) therapy with imatinib, dasatinib, and nilotinib. DESIGN: Retrospective cohort study. DATA SOURCE: Veterans Health Administration (VHA) national database. PATIENTS: A total of 2,873 VHA beneficiaries aged 18-89 years who had at least one encounter at any of the approximately 150 VHA hospitals and 800 VHA clinics, had a diagnosis code for chronic myeloid leukemia, and filled at least one prescription for imatinib, nilotinib, or dasatinib between October 1, 2001, and September 30, 2010...
January 4, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28035692/application-of-a-risk-score-to-identify-older-adults-with-community-onset-pneumonia-most-likely-to-benefit-from-empiric-pseudomonas-therapy
#10
Christopher R Frei, Sylvie Rehani, Grace C Lee, Natalie K Boyd, Erene Attia, Ashley Pechal, Rachel S Britt, Eric M Mortensen
STUDY OBJECTIVE: To assess the impact of empiric Pseudomonas pharmacotherapy on 30-day mortality in hospitalized patients with community-onset pneumonia stratified according to their risk (low, medium, or high) of drug-resistant pathogens. DESIGN: Retrospective cohort study. DATA SOURCE: Veterans Health Administration database. PATIENTS: A total of 50,119 patients who were at least 65 years of age, hospitalized with pneumonia, and received antibiotics within 48 hours of admission between fiscal years 2002 and 2007; patients were stratified into empiric Pseudomonas therapy (31,027 patients) and no Pseudomonas therapy (19,092 patients) groups based on antibiotics received during their first 48 hours of admission...
December 30, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28035690/%C3%AE-lactam-therapy-for-methicillin-susceptible-staphylococcus-aureus-bacteremia-a-comparative-review-of-cefazolin-versus-antistaphylococcal-penicillins
#11
Julius Li, Kelly L Echevarria, Kristi A Traugott
Methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia is associated with high morbidity and mortality. Traditionally, antistaphylococcal penicillins (ASPs) have been considered the agents of choice for the treatment of MSSA bacteremia. Vancomycin has been demonstrated to have poorer outcomes in several studies and is only recommended for patients with severe penicillin allergies. Although cefazolin is considered as an alternative to the ASPs for patients with nonsevere penicillin allergies, cefazolin offers several pharmacologic advantages over ASPs, such as more convenient dosing regimens, and antimicrobial stewardship programs are increasingly using cefazolin as the preferential agent for MSSA infections as part of cost-saving initiatives...
December 30, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28035686/interaction-between-atypical-antipsychotics-and-the-gut-microbiome-in-a-bipolar-disease-cohort
#12
Stephanie A Flowers, Simon J Evans, Kristen M Ward, Melvin G McInnis, Vicki L Ellingrod
OBJECTIVES: The atypical antipsychotic (AAP) class is often associated with metabolic disease, but the mechanistic underpinnings of this risk are not understood. Due to reports linking gut bacteria function to metabolic disease, we hypothesize that AAP-treatment in adults results in gut dysbiosis potentiating metabolic criteria. This report describes recent findings linking AAP-treatment with differences in gut microbiota communities in a human cohort with bipolar disorder (BD). METHODS: In a cross- sectional design, we obtained 16S ribosomal sequences from 117 BD patients (49 AAP-treated, 68 non-AAP treated)...
December 30, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28028855/odds-of-viral-suppression-by-single-tablet-regimens-multiple-tablet-regimens-and-adherence-level-in-hiv-aids-patients-receiving-antiretroviral-therapy
#13
S Scott Sutton, Joseph Magagnoli, James W Hardin
STUDY OBJECTIVE: To evaluate the odds of achieving viral suppression in HIV patients utilizing antiretroviral therapy as a single-tablet regimen (STR) or multiple-tablet regimen (MTR). DESIGN: Retrospective cohort study. DATA SOURCES: South Carolina Medicaid medical and pharmacy paid claims data were obtained from the South Carolina Revenue and Fiscal Affairs Office; laboratory data were obtained from the South Carolina Department of Health and Environmental Control...
December 27, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/28028830/retrospective-evaluation-of-postoperative-adverse-drug-events-in-patients-receiving-rivaroxaban-following-major-orthopedic-surgery-compared-to-standard-therapy-in-a-community-hospital
#14
Nicole E Cieri, Kristen Kusmierski, Cynthia Lackie, August Van Opdorp, Amany Hassan
STUDY OBJECTIVES: To evaluate the occurrence of bleeding and venous thromboembolic (VTE) events in patients receiving rivaroxaban, warfarin, or warfarin with the addition of enoxaparin during the immediate post-operative period following major orthopedic surgery. METHODS: Patients older than 18 years who received at least one dose of rivaroxaban the morning following surgery, adjusted dose warfarin, or adjusted dose warfarin with the addition of enoxaparin for VTE prophylaxis following major orthopedic surgery between October 1, 2011 and February 28, 2015 were included...
December 27, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27997676/development-of-a-predictive-model-for-drug-related-problems-in-kidney-transplant-recipients
#15
Kelly L Covert, Caitlin R Mardis, James N Fleming, Nicole A Pilch, Holly B Meadows, Benjamin A Mardis, Prince Mohan, Maria Posadas-Salas, Titte Srinivas, David J Taber
STUDY OBJECTIVE: Drug-related problems (DRPs) are associated with increased rates of infection, rejection, and graft loss in kidney transplant recipients. This study aimed to develop a model to predict which patients are at highest risk of DRPs to streamline pharmacists' workflow in a chronic kidney transplant clinic. DESIGN: Prospective observational study. SETTING: Chronic kidney transplant clinic at a large, tertiary care, academic hospital...
December 20, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27997675/compliance-with-procalcitonin-algorithm-antibiotic-recommendations-for-patients-in-medical-intensive-care-unit
#16
Abdalla A Ammar, Simon W Lam, Abhijit Duggal, Elizabeth A Neuner, Stephanie N Bass, Jorge A Guzman, Xiao-Feng Wang, Xiaozhen Han, Seth R Bauer
STUDY OBJECTIVES: To describe compliance with antibiotic recommendations based on a previously published procalcitonin (PCT)-guided algorithm in clinical practice, to compare PCT algorithm compliance rates between PCT assays ordered in the antibiotic initiation setting (PCT concentration measured < 24 hours after antibiotic initiation or prior to antibiotic initiation) with those in the antibiotic continuation setting (PCT concentration measured ≥ 24 hours after antibiotic initiation), and to evaluate patient- and PCT-related factors independently associated with algorithm compliance in patients in the medical intensive care unit...
December 20, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27995648/pharmacotherapy-cover-story-and-updates
#17
C Lindsay DeVane
No abstract text is available yet for this article.
December 20, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27995643/loperamide-trends-in-abuse-and-misuse-over-13-years-2002-2015
#18
Daniel R Lasoff, Cynthia H Koh, Bryan Corbett, Alicia B Minns, F Lee Cantrell
STUDY OBJECTIVE: With the increasing amount of information available on the Internet describing techniques for using loperamide either for self-treatment of opioid withdrawal syndromes or for recreational use ("legal highs"), the objective was to describe a statewide poison control system's experience with loperamide misuse and abuse, with specific interest in cases of cardiotoxicity, and to determine if there has been a recent increase in reported loperamide misuse or abuse cases. DESIGN: Retrospective review...
December 20, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27983753/effectiveness-and-safety-of-tigecycline-compared-with-other-broad-spectrum-antimicrobials-in-abdominal-solid-organ-transplant-recipients-with-polymicrobial-intraabdominal-infections
#19
Tyler Liebenstein, Lucas T Schulz, Chris Viesselmann, Emma Bingen, Jackson Musuuza, Nasia Safdar, Warren E Rose
STUDY OBJECTIVE: As patients with abdominal solid organ transplants (SOT) are at increased risk of polymicrobial intraabdominal infections (IAIs) following transplantation, the objective of this study was to compare the effectiveness and adverse event profile of tigecycline with those of other broad-spectrum therapies for polymicrobial IAIs in this population. DESIGN: Retrospective cohort study. SETTING: Large academic medical center with multiple outpatient clinics...
December 16, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27983747/laboratory-and-clinical-monitoring-of-direct-acting-oral-anticoagulants-what-clinicians-need-to-know
#20
Susan E Conway, Andrew Y Hwang, Charles D Ponte, John G Gums
The direct acting oral anticoagulants (DOACs) including dabigatran, rivaroxaban, apixaban, and edoxaban, have favorable pharmacokinetic and pharmacodynamic properties and equal or superior efficacy and an improved safety profile compared to warfarin. Noted shortcomings with DOACs are shorter half-lives requiring stricter adherence, lack of standardized laboratory monitoring, lack of anticoagulation reversal agents, and loss of routine coagulation monitoring leading to fewer patient-clinician interactions. This review addresses many of these limitations including monitoring of DOACs for efficacy and toxicity, an assessment of selected qualitative and quantitative tests, and development of monitoring strategies for special populations...
December 16, 2016: Pharmacotherapy
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