Device-Related Thrombosis in Continuous-Flow Left Ventricular Assist Device Support
Advanced heart failure therapy has been revolutionized with the advent of continuous-flow ventricular assist devices (CF-LVADs) which have improved both survival and quality of life. Despite this, support with CF-LVADs is frequently complicated, with 70% of recipients experiencing a major complication in the first year of durable support. The most concerning of these complications to emerge is device-related thrombosis, which is associated with increased morbidity and mortality. Pathophysiology and diagnosis are multifaceted and complex, with pump-specific and patient-specific factors to be considered. Incidence estimates ...
Source: Journal of Pharmacy Practice - January 11, 2016 Category: Drugs & Pharmacology Authors: Doligalski, C. T., Jennings, D. L. Tags: Cardiology Pharmacotherapy Source Type: research
Emerging Therapies for Acute and Chronic Heart Failure: Hope or Hype?
Although the period from 1953 to 2001 resulted in the approval of more than 30 medications currently used to treat heart failure (HF), few novel drugs have been approved in the last decade. However, the investigational pipeline for HF medications once again appears promising. In patients with chronic heart failure with reduced ejection fraction (HFrEF), ivabradine and valsartan/sucubitril (LCZ696) were recently approved by the US Food and Drug Administration. Both agents have been shown to reduce the risk of cardiovascular death and HF hospitalization. In the treatment of acute HF, serelaxin and ularitide are the farthest ...
Source: Journal of Pharmacy Practice - January 11, 2016 Category: Drugs & Pharmacology Authors: Hanigan, S., DiDomenico, R. J. Tags: Cardiology Pharmacotherapy Source Type: research
Critical Review and Update on the Treatment of Acute and Chronic Pulmonary Embolism
Pulmonary embolism (PE), can be life-threatening without rapid appropriate therapy and often leads to chronic disease and disability. The ambiguity of symptoms makes PE difficult to diagnose, and available imaging strategies have their limitations. Treatment options for acute PE include fibrinolytics, surgical embolectomy, catheter-directed treatment, or vena cava filter placement as well as traditional parenteral anticoagulants, used alone or as a bridge to a vitamin K antagonist (VKA). The direct oral anticoagulants (DOACs) rivaroxaban and apixaban allow for single drug therapy, eliminating the need for initial parentera...
Source: Journal of Pharmacy Practice - January 11, 2016 Category: Drugs & Pharmacology Authors: Shapiro, N. L., Bhatt, S. H. Tags: Cardiology Pharmacotherapy Source Type: research
Clopidogrel Response Variability: Review of the Literature and Practical Considerations
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is standard therapy following acute coronary syndrome and percutaneous coronary intervention. Despite the use of potent antiplatelet agents, vascular events continue to occur. Lack of response to clopidogrel therapy has been widely investigated using various methods of platelet function testing. These studies have consistently found an association between poor clopidogrel response and an increased risk of vascular events. Strategies to overcome this problem include higher clopidogrel doses or the use of an alternative P2Y12 agent. To date, the majority of studies...
Source: Journal of Pharmacy Practice - January 11, 2016 Category: Drugs & Pharmacology Authors: Oliphant, C. S., Trevarrow, B. J., Dobesh, P. P. Tags: Cardiology Pharmacotherapy Source Type: research
Current Controversies With Recent Cholesterol Treatment Guidelines
Several guidelines and expert recommendations have been published recently regarding the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD) risk. The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend a drastic paradigm change in the treatment of cholesterol where treatment, based on level of cardiovascular risk, is based around using a fixed statin intensity therapy. This approach is endorsed by the American Diabetes Association. However, recommendations by the National Lipid Association (NLA) consist of the traditional approach of titrating therapy to achieve ...
Source: Journal of Pharmacy Practice - January 11, 2016 Category: Drugs & Pharmacology Authors: Phillips, E., Saseen, J. J. Tags: Cardiology Pharmacotherapy Source Type: research
Controversies Among the Hypertension Guidelines
Hypertension affects 80 million people in the United States. It remains poorly controlled, with only 54% of diagnosed patients treated to blood pressure targets. Hypertension management is complex in part due to the volume of antihypertensive agents, variable patient needs and responses, and inconsistent design and outcomes from clinical trials. Therefore, trustworthy clinical practice guidelines have a key role in hypertension management. The United States experienced a 10-year gap in publication of hypertension guidelines, followed by multiple guideline publications in 2013. These guidelines led to more controversy than ...
Source: Journal of Pharmacy Practice - January 11, 2016 Category: Drugs & Pharmacology Authors: Ripley, T. L., Baumert, M. Tags: Cardiology Pharmacotherapy Source Type: research
Presidential Address: Leadership - Its Not Just for Managers Anymore
(Source: Journal of Pharmacy Practice)
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Seyse, S. Tags: New York State Council of Health-system Pharmacists Section Source Type: research
Evaluating Patients Understanding of Printed Warfarin Medication Information
Conclusion:
This study demonstrates gaps in patients’ understanding of warfarin therapy. Relying solely on the information in the FDA medication guide is insufficient to guarantee adequate understanding. Utilizing the suggestions from patients’ feedback on other ways to deliver information should help future patients with different learning abilities and styles. (Source: Journal of Pharmacy Practice)
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Schwartz, L., Mazzola, N., Hoffman, R. S., Howland, M. A., Mercurio-Zappala, M., Nelson, L. S. Tags: Research Articles Source Type: research
Presidential Address: Leadership - It's Not Just for Managers Anymore
(Source: Journal of Pharmacy Practice)
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Seyse, S. Tags: New York State Council of Health-system Pharmacists Section Source Type: research
Engaging Pharmacy Students, Residents, and Fellows in Antimicrobial Stewardship
Antimicrobial stewardship programs are mainly established by infectious diseases physicians and infectious diseases-trained clinical pharmacists with the goal of optimizing patients’ outcomes while halting antimicrobial resistance, decreasing adverse events, and controlling health care cost. The role of the infectious diseases-trained clinical pharmacist in antimicrobial stewardship is well established; however, there are not enough formally trained pharmacists to assume the challenging responsibilities of the steward coordinator. The purpose of this article was to review the available literature and resources and pr...
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Chahine, E. B., El-Lababidi, R. M., Sourial, M. Tags: Pharmacy Education Source Type: research
A Research Elective Course on Dietary Supplements to Engage Doctor of Pharmacy Students in Primary Literature Evaluation and Scholarly Activity
Conclusions:
The course provided opportunity to the pharmacy students to not only critically search and evaluate the literature but also publish in peer-reviewed journals. Other pharmacy schools/colleges can adopt this course model to create opportunities for student–faculty collaborations toward scholarly accomplishments. (Source: Journal of Pharmacy Practice)
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Islam, M. A., Gunaseelan, S., Khan, S. A. Tags: Pharmacy Education Source Type: research
Pentoxifylline-Induced Thrombocytopenia: A Case Report
We describe a 72-year-old Chinese male who developed thrombocytopenia after initiation of pentoxifylline for the treatment of chronic lower limb ischemia due to peripheral artery disease. Venous thromboembolism had been ruled out with an ultrasound. Vascular surgeons had also determined there was no indication for surgical intervention. Four days after initiation of pentoxifylline, he developed thrombocytopenia, and his platelets were 68 x 103/μL. He was not in overt disseminated intravascular coagulation (DIC), based on his International Society for Thrombosis and Hemostasis (ISTH) DIC score of 4. Dengue fever, which i...
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Tan, M. W., Sklar, G. E. Tags: Adverse Drug Event Source Type: research
A Comprehensive Review of Potential Warfarin-Fruit Interactions
Conclusion:
Although a number of case reports have been published that suggest warfarin has the potential to interact with several fruit products, it is difficult to determine their relevance, as scientific evidence is scarce. Until further information is available, clinicians may want to encourage patients to consume cranberry products and grapefruit juice in small to moderate quantities and to inquire about the recent consumption of mangos, pomegranate juice, and avocados when taking a dietary history or when assessing possible causes for international normalized ratio (INR) instability. (Source: Journal of Pharmacy Practice)
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Norwood, D. A., Parke, C. K., Rappa, L. R. Tags: Review Articles Source Type: research
What Is the Appropriate Duration of High-Dose Atorvastatin Therapy Post-Acute Coronary Syndrome?
Conclusion:
After an ACS, high-dose atorvastatin should be continued for at least 5 years. High-dose atorvastatin demonstrated a reduction in coronary events but dose reductions and higher discontinuation rates were also noted. (Source: Journal of Pharmacy Practice)
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Goriacko, P., Andersen, M., Fazylov, R., Plakogiannis, R. Tags: Review Articles Source Type: research
Idarucizumab, a Humanized, Monoclonal Antibody Fragment for Immediate Reversal of Dabigatran
Conclusion:
Idarucizumab represents an encouraging development in the reversal of dabigatran. Its novel mechanism of action, pharmacokinetics, tolerability, and lack of thrombotic events contribute positively to its use in patients who experience bleeding or for those who require emergent surgery or procedures. (Source: Journal of Pharmacy Practice)
Source: Journal of Pharmacy Practice - November 15, 2015 Category: Drugs & Pharmacology Authors: Miyares, M. A., Kuyumjian, Y., Eaves, S., Dollard, E. Tags: Review Articles Source Type: research
