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 · Feb 2019
Variability in training, practice, and prioritization of services among emergency medicine pharmacists.
The purpose of this survey-based research project is to identify factors, including prior training, institution demographics, and pharmacist prioritization of services that may impact variability in practice among emergency medicine (EM) pharmacists. ⋯ Institution and ED demographics as well as pharmacist level of training can affect the frequency of services provided in the ED setting.
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Am J Health Syst Pharm · Feb 2019
ReviewMusculoskeletal toxicities in patients receiving concomitant statin and daptomycin therapy.
This article evaluates the musculoskeletal safety of concomitant therapy with daptomycin and Hydroxymethylglutaryl-coenzyme A (HMG CoA) reductase inhibitors (statins). ⋯ Published cohort studies do not demonstrate a statistically significant difference in the rate of CPK elevations or musculoskeletal toxicities between patients receiving daptomycin monotherapy and daptomycin plus a statin. Patients receiving statins who start daptomycin therapy should continue statin but with weekly monitoring of CPK levels. Continuation of statins is especially important in high-risk patients receiving statins for secondary prevention for atherosclerotic cardiovascular diseases. If myalgia develops, it is reasonable to evaluate the degree of CPK elevation and reassess the need for statin use during daptomycin treatment.
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Am J Health Syst Pharm · Jan 2019
Multicenter StudyPharmacist-led antimicrobial stewardship program in an urgent care setting.
While many programs have demonstrated pharmacist-led antimicrobial stewardship successes in inpatient and emergency department (ED) settings, there is a paucity of literature exploring these initiatives in urgent care (UC) sites. This study aimed to determine the impact of implementing a pharmacist-led antimicrobial stewardship program (ASP) in the UC setting. ⋯ A pharmacist-led urgent care ASP was associated with significantly improved guideline-concordant antimicrobial prescribing.
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Am J Health Syst Pharm · Jan 2019
ReviewRole of angiotensin II in treatment of refractory distributive shock.
Clinical data and gaps in knowledge regarding angiotensin II (AT2), which was approved by the Food and Drug Administration in December 2017 via priority review for treatment of septic and other vasodilatory shock, is discussed. ⋯ Intravenous AT2 represents a novel treatment strategy for refractory septic or other vasodilatory shock, although findings of safety and efficacy have not been replicated and the drug's optimal place in therapy is uncertain.
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Am J Health Syst Pharm · Jan 2019
Case ReportsReversal of dabigatran requiring hemodialysis, fresh frozen plasma, and 2 doses of idarucizumab in a patient with acute kidney injury.
A case report of dabigatran-associated coagulopathy that lasted for about 1 week after drug discontinuation despite use of several treatment measures is presented. ⋯ A patient with AKI who had been taking dabigatran and developed major bleeding needed 2 doses of idarucizumab in addition to FFP and 3 sessions of hemodialysis in order for hemostasis to be restored. This case suggests that idarucizumab might not produce hemostasis in a timely manner in patients with poor renal function.