Journal of the American Pharmacists Association : JAPhA
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Sleep is an active process consisting of macro- and microarchitectural rhythms, chronobiology, and neurochemical changes. Disruptions in sleep chronobiology, which may occur in shift workers and the elderly or due to jet lag, often respond to exogenous melatonin. ⋯ Treatment options include sleep hygiene principles and sedative hypnotic therapy. Zaleplon and zolpidem, short-acting benzodiazepines selective for omega-1 GABA receptors, are effective first-line agents for initiating sleep.
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Foot ulcers are a major cause of disability, morbidity, and mortality in people with diabetes. The three major etiological factors for diabetic foot ulcers are peripheral neuropathy, peripheral vascular disease, and infection. ⋯ Becaplermin gel, a prescription, recombinant wound-healing therapy, may be used to promote healing of diabetic foot ulcers in select patients. Pharmacists can make a significant contribution to the prevention of diabetic foot ulcers and lower extremity amputations.
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Undertreatment of pain continues to be a serious public health problem. The use of opioid analgesics is considered essential for chronic pain management and palliative care. Pharmacists are encouraged to become involved in initiatives to improve pain management.