Pharmacotherapy
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To assess antihypertensive treatment practices and outcomes for patients with acute severe hypertension requiring hospitalization. ⋯ Pharmacologic treatment of acute severe hypertension in patients with nonneurologic causes is heterogeneous and often not consistent with Joint National Committee recommendations. Patients received numerous intravenous agents, experienced variable decreases in SBP, often failed to receive timely oral therapy, and a clinically relevant proportion developed hypotension.
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Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a rare neurodegenerative disease caused by the decreased ability of cells to produce sufficient energy in the form of adenosine 5'-triphosphate. Although it is one of the most common maternally inherited mitochondrial disorders, its exact incidence is unknown. Caused most frequently by an A-to-G point mutation at the 3243 position in the mitochondrial DNA, MELAS syndrome has a broad range of clinical manifestations and a highly variable course. ⋯ Some of the most frequently prescribed agents include coenzyme Q(10), l-arginine, B vitamins, and levocarnitine. Although articles describing MELAS syndrome are available, few specifically target education for clinical pharmacists. This article will provide pharmacists with a practical resource to enhance their understanding of MELAS syndrome in order to provide safe and effective pharmaceutical care.