The Annals of pharmacotherapy
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Although risk factors for torsade de pointes (TdP) are known, identifying hospitalized patients at greatest risk for QTcP who should receive cardiac monitoring is poorly defined. ⋯ Of the population receiving QTcMeds, only a small portion had a baseline ECG, identifying a large population at risk of QTcP without appropriate monitoring. Patients with cardiac disease receiving probable-risk QTcMeds were associated with the highest risk of QTcP and should be monitored closely.
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Beginning in fiscal year 2015, the Centers for Medicare and Medicaid Services will measure all-cause readmissions for patients admitted for exacerbation of chronic obstructive pulmonary disease (COPD). Hospitals will incur a payment penalty for unplanned 30-day readmissions. Elderly patients frequently present a challenge because of polypharmacy, which contributes to a greater risk for medication-related readmissions. ⋯ Pharmacist-conducted medication reconciliation at discharge decreased discrepancies for elderly patients admitted for exacerbation of COPD. The 30-day readmission rate could be decreased further by expanding pharmacist responsibilities during transitions of care. This includes patient counseling, tracking outpatient adherence, selecting affordable medications, and expanding the process to include other chronic disease states.
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To describe the diagnosis, management, and monitoring of a patient with heparin-induced thrombocytopenia (HIT) with thrombosis and simultaneous bleeding risk treated with argatroban and transitioned to intravenous (IV) warfarin secondary to the inability to administer enteral medications. ⋯ IV warfarin is a therapeutic option for patients with malabsorption issues. A multidisciplinary team in an intensive care setting optimizes cost-effective, patient-centered, and safe care.