The Annals of pharmacotherapy
-
To assess the real-world implications of oral tenofovir-emtricitabine (TDF-FTC) for HIV preexposure prophylaxis (PrEP) in clinical practice and highlight important considerations for its implementation. ⋯ The greatest impact of PrEP, both clinically and financially, will likely arise from judicious application in select high-risk populations. If used appropriately, PrEP has the potential to augment reductions in the current incidence of new HIV infections, and pharmacists will have an important role in the careful selection and counseling of these targeted populations.
-
Comparative Study
Use of propofol-containing versus benzodiazepine regimens for alcohol withdrawal requiring mechanical ventilation.
When chronic, excessive alcohol intake is abruptly halted, patients are at risk for developing life-threatening alcohol withdrawal syndrome (AWS). Benzodiazepines have established efficacy, yet some patients' symptoms persist despite treatment with high doses. ⋯ Propofol and Benzodiazepine-treated patients with AWS requiring mechanical ventilation experienced similar days of AWS symptoms, length of stay, and mechanical ventilation.
-
Observational Study
An interprofessional approach to reducing the overutilization of stress ulcer prophylaxis in adult medical and surgical intensive care units.
Overutilization of stress ulcer prophylaxis (SUP) in the intensive care unit (ICU) is common. Acid-suppressive therapies routinely used for SUP are best reserved for patients with greatest risk of clinically important bleeding as they have been associated with nosocomial pneumonia, Clostridium difficile infection and increased hospital cost. ⋯ Implementation of an interprofessional bundled quality improvement initiative is effective in decreasing inappropriate use of SUP in adult medical and surgical ICUs at a university-affiliated, tertiary care academic medical center.
-
To review the pharmacology, safety, and efficacy of dolutegravir, an integrase strand-transfer inhibitor (INSTI), and to discuss its role in the treatment of HIV-1-infected patients. ⋯ Dolutegravir is the first second-generation INSTI and exhibits several advantages over current integrase inhibitors and other preferred antiretrovirals. Long-term efficacy and safety are needed to define dolutegravir's role in treatment.
-
Comparative Study
Intravenous metoprolol versus diltiazem for rate control in noncardiac, nonthoracic postoperative atrial fibrillation.
Little guidance exists on effective management of postoperative atrial fibrillation (POAF) following noncardiac, nonthoracic (NCNT) surgery. ⋯ In NCNT surgery, patients with POAF, IV diltiazem more effectively controlled HR and hemodynamics compared with metoprolol. Results warrant further research into optimal medical management of POAF in this population using these 2 agents.