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 · Mar 2011
ReviewSpecial considerations for treatment of type 2 diabetes mellitus in the elderly.
The intensity and selection of therapy for the treatment of type 2 diabetes mellitus in elderly patients are discussed. ⋯ In the absence of clear evidence advocating strict glycemic targets goal of <7% is for elderly patients, an HbA(1c) reasonable for most patients; however, the risk of hypoglycemic complications must be weighed against the potential benefit of reducing microvascular and macrovascular disease. Metformin may be used as first-line therapy, but chlorpropamide and glyburide, which pose a great risk for hypoglycemia, should be avoided in the elderly. Due to increased cardiovascular risk, use of rosiglitazone in the elderly should also be avoided.
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Am J Health Syst Pharm · Mar 2011
Developing policy, standard orders, and quality-assurance monitoring for palliative sedation therapy.
The development of a policy, evidence-based standard orders, and monitoring for palliative sedation therapy (PST) is described. ⋯ Development of policy, standard orders, and quality-assurance monitoring for PST required a formal multidisciplinary process. A process-improvement process is critical to defining institutional policy, educational goals, and outcome metrics for PST.