The Annals of pharmacotherapy
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Review Comparative Study
Efficacy and safety of ticagrelor: a reversible P2Y12 receptor antagonist.
To summarize the pharmacokinetic and pharmacodynamic properties of ticagrelor, a selective P2Y12 receptor antagonist, and evaluate its role in the treatment of patients with acute coronary syndromes (ACS). ⋯ Ticagrelor's improved pharmacokinetic and pharmacodynamic profile builds upon the limitations of currently available P2Y12 receptor antagonists. Ticagrelor represents a promising approach for the prevention of cardiovascular events in patients with ACS.
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Clinicians practicing in Emergency Departments (EDs) using outdated pocket guides and other non-pregnancy-specific references when prescribing in pregnancy may place the pregnancy or fetus at risk. ⋯ EM clinicians rely on general references to make prescribing decisions for pregnant patients and are willing to prescribe medications that have data to support safe use in pregnancy. A minority of EM clinicians acknowledged the availability of pregnancy-specific references in the ED. Increased awareness of references that incorporate human data into their pharmacotherapy recommendations is warranted to assist EM clinicians in achieving their goal of prescribing safely in the pregnant patient.
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An organized and uniform approach to managing sedation in critically ill patients has been associated with improved outcomes, but the most effective means of optimizing sedative medication use in clinical practice has not been fully determined. Pharmacist interventions directed at improving sedation guideline compliance have been shown to reduce the duration of mechanical ventilation. ⋯ Tele-ICU resources can be utilized to increase compliance with an established ICU sedation guideline and extend the benefits that daytime ICU clinical pharmacy services provide. Increased ICU pharmacist availability may have additional benefits not measured in this study.
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To review certolizumab pegol for the treatment of moderate-to-severe Crohn's disease (CD). ⋯ With similarity in cost and the lack of head-to-head comparisons, patient and physician preference may determine choice of TNF-alpha antagonist.
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To evaluate the literature examining the efficacy of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) for migraine prophylaxis. ⋯ ACE inhibitors and ARBs have migraine prophylaxis activity similar to that of some currently utilized agents. Low-dose lisinopril or candesartan may be reasonable second- or third-line agents, particularly in patients with other indications for ACE inhibitor or ARB therapy. Further controlled clinical trials are needed to delineate the role of these agents in migraine prevention.