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.
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Am J Health Syst Pharm · Feb 2011
ReviewCalcium supplementation in postmenopausal women to reduce the risk of osteoporotic fractures.
The most recent large-scale studies evaluating the effects of calcium supplementation for prevention of osteoporosis-related fractures in postmenopausal women are reviewed. ⋯ Results of recent clinical trials indicate that calcium supplementation does not significantly reduce fracture risk in postmenopausal women. However, evidence from the same studies suggests that beneficial effects on fracture risk may be seen in women who are adherent to therapy. Postmenopausal women should continue calcium supplementation to reduce osteoporosis risk.