American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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Am J Health Syst Pharm · May 2010
ReviewIntensive glucose control in the management of diabetes mellitus and inpatient hyperglycemia.
The current evidence on intensive glycemic control in the inpatient and outpatient settings and its implications to practice are reviewed. ⋯ While intensive glycemic control is known to prevent or delay the occurrence of microvascular complications of diabetes, macrovascular benefits are still uncertain. Current evidence suggests that intensive glycemic control should be initiated as soon as possible after diagnosis of type 1 or type 2 diabetes in order to maximize potential long-term macrovascular benefits. Inpatient hyperglycemia should be managed appropriately to reduce morbidity and mortality, with great care taken to avoid and appropriately treat hypoglycemia.
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Am J Health Syst Pharm · May 2010
Case ReportsClinical and management challenges in preventing venous thromboembolism in health systems: a case-based panel discussion.
To illustrate clinical and management issues in the prevention of venous thromboembolism (VTE) in health systems. ⋯ An understanding of the clinical and management issues involved in preventing VTE is needed to improve the use of anticoagulants and reduce the incidence of VTE in health systems.
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Am J Health Syst Pharm · May 2010
Case ReportsFatal retroperitoneal hematoma after enoxaparin administration in a patient with paroxysmal atrial flutter.
A case of fatal retroperitoneal hematoma that developed after enoxaparin administration in a woman with paroxysmal atrial flutter and chest pain is reported. ⋯ A 63-year-old African-American woman with a 24-hour history of severe, nonexertional chest pain and new-onset paroxysmal atrial flutter without ST-segment elevation was treated with enoxaparin and subsequently died of a fatal spontaneous retroperitoneal hematoma.
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Am J Health Syst Pharm · May 2010
ReviewImproving the quality of care for patients at risk for venous thromboembolism.
To describe risk factors for venous thromboembolism (VTE), quality improvement efforts for VTE prevention, and strategies health-system pharmacists can use to improve anticoagulant use and outcomes in patients at risk for VTE. ⋯ The use of anticoagulant therapy presents health-system pharmacists with both challenges and opportunities to improve the quality of care in patients at risk for VTE.
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Herpes zoster, herpes zoster vaccine, and the cost-effectiveness of the vaccine are reviewed. ⋯ The herpes zoster vaccine is effective in preventing herpes zoster and decreasing the incidence of complications. However, insurance coverage may hinder eligible patients from receiving the vaccination.