Thursday, December 19, 2013

JNC 8 Guidelines Update

http://www.medscape.com/viewarticle/817991

Nine Recommendations
Those questions then form the basis for nine recommendations, discussed in depth and assigned a score for both the strength of the recommendation and the evidence supporting it. Among the recommendations:
  • In patients 60 years or over, start treatment in blood pressures >150 mm Hg systolic or >90 mm Hg diastolic and treat to under those thresholds.
  • In patients <60 140="" and="" be="" goals="" hg="" in="" initiation="" mm="" patients="" same="" should="" the="" threshold="" treatment="" u="" used="" years="">>
18 years with either chronic kidney disease (CKD) or diabetes.
  • In nonblack patients with hypertension, initial treatment can be a thiazide-type diuretic, CCB, ACE inhibitor, or ARB, while in the general black population, initial therapy should be a thiazide-type diuretic or CCB.
  • In patients >18 years with CKD, initial or add-on therapy should be an ACE inhibitor or ARB, regardless of race or diabetes status.
  • Tuesday, December 17, 2013

    Embedding pharmacists throughout a health system

    Phillip Olley, PharmD, talks with Michelle Ma, RN, flow coordinator 
     (left) and Zin Mie Oo, MD, infectious disease fellow (right)


    From APhA

    It's almost end of 2013. This is what pharmacist can do and we definitely can make a difference. Keep up the good work everyone!

    Many Faces of MTM
    Froedtert Hospital joins with two community hospitals and 30 clinics to make up Froedtert & the Medical College of Wisconsin, which has 772 beds, nearly 40,000 annual admissions, and more than 900,000 annual outpatient visits.
    Pharmacists are everywhere at Froedtert & the Medical College of Wisconsin Froedtert Hospital. From the moment patients enter the hospital to the moment they leave, pharmacists play an active role in managing and monitoring medications. 
    “We have pharmacists on the [hospital] floors, in ambulatory clinics, and in medical homes, so our pharmacists really take ownership of the patient no matter where he or she is in the transition of care,” said Erika Smith, PharmD, Clinical Pharmacy Manager at Froedtert Hospital in Milwaukee.
    With more than 200 pharmacists, pharmacy technicians, and pharmacy administration and informatics team members, Froedtert Hospital has a longstanding history of embedding pharmacists at transition points in the hospital.
    Four clinical pharmacy managers are aligned with each medical service line and manage the corresponding inpatient pharmacy services all the way through ambulatory pharmacy services. This model helps the organization and its pharmacists gain a better understanding of how pharmacy services can best meet the needs of patients.

    Read More [Click Here]

    Saturday, October 26, 2013

    Monday, August 26, 2013

    FDA Approvals: Plasma-Derived Agent for Anticoagulation Reversal

    Patients with atrial fibrillation or an artificial heart valve often need long-term anticoagulation to reduce their high risk for thrombotic events. Warfarin and other vitamin K antagonist (VKA) anticoagulants can prevent thrombosis, but there is an increased risk of major bleeding.
    Human prothrombin complex concentrate can be used more quickly than plasma for reversal of VKA anticoagulation, as it can be used without blood group typing or thawing. This therapy offers clinicians a new option for patients requiring urgent reversal of VKA anticoagulation.
    cont. reading 

    Monday, April 15, 2013

    New Drugs Approved for Treating Hypercholesterolemia

    Unique mechanisms of action

    Lomitapide is a microsomal triglyceride transfer protein (MTP) inhibitor. MTP resides in the lumen of the endoplasmic reticulum, thereby preventing the assembly of apo B–containing lipoproteins in enterocytes and hepatocytes. This inhibition leads to a reduction in the synthesis of chylomicrons and very low–density lipoprotein, resulting in a reduction in plasma LDL levels. This is the first MTP inhibitor approved by FDA for any indication.
    Mipomersen is an oligonucleotide inhibitor of apo B-100 synthesis that reduces LDL cholesterol by preventing the formation of atherogenic lipids. It decreases the production of apo B, which provides the structural core for all atherogenic lipids, including LDL cholesterol, which carry cholesterol through the bloodstream.

    VERY COOL! :)

    Ref: Pharmacy Today 2013 (APhP)

    Strategy for managing acid suppression in the ICU

    http://www.pharmacypracticenews.com//ViewArticle.aspx?ses=ogst&d=Operations+%26+Management&d_id=53&i=ISSUE%3a+April+2013&i_id=950&a_id=22973

    Every evening during a two-month verification phase, tele-ICU nurses assessed the risk for GI bleeding for each patient in the 38-bed ICU at one of the system’s hospitals. The three-week intervention phase that followed involved all adult ICU beds. On-site nurses and pharmacists recommended 102 conversions from IV to oral PPIs; 86 (84.3%) were accepted. Discontinuation of SUP was recommended 173 times; prescribers accepted 91 (52.6%) of the recommendations. The cost of SUP treatment decreased from $1.06 per adjusted patient-day to 77 cents and the projected annual cost savings from decreased SUP amounted to $78,052.

    from Pharmacy Practice News 2013

    Wednesday, January 30, 2013

    Pharmacologic and Complementary Therapy for Migraine Prophylaxis

    Ref: US Pharmacist

     

    The revised guidelines developed by the AAN and the AHS for the use of pharmacologic agents and complementary therapies for migraine prophylaxis provide recommendations that were based on evidence-based clinical trials conducted after the release of the 2000 guidelines. This in-depth analysis gives an oversight of the methods, designs, and results of the clinical trials examining the efficacy of these agents. The updated guidelines address new therapies for the short-term prevention of MAM, namely, frovatriptan, naratriptan, and zolmitriptan. Also, new evidence in correlation with already established trial-based evidence supports the ineffectiveness of lamotrigine for migraine prophylaxis. Finally, the use of complementary therapies, such as herbal formulations, for migraine prophylaxis has been advanced by evidence-based efficacy in clinical trials, providing a new arsenal of evidence-based treatment during a time when the use of herbal formulations has become increasingly popular.

     http://www.uspharmacist.com/content/d/feature/c/38550/