CONSULTANT PHARMACIST最新文献_第6页

A Case Report on Pregabalin-Induced Eosinophilia. 普瑞巴林致嗜酸性粒细胞增多1例报告。

CONSULTANT PHARMACIST Pub Date : 2018-06-01 DOI: 10.4140/TCP.n.2018.317

Raj Shilpa, T P Sreekrishnan, K P Gireesh Kumar, C M Neethu

{"title":"A Case Report on Pregabalin-Induced Eosinophilia.","authors":"Raj Shilpa, T P Sreekrishnan, K P Gireesh Kumar, C M Neethu","doi":"10.4140/TCP.n.2018.317","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.317","url":null,"abstract":"This is a case report on a 77-year-old diabetic patient with peripheral neuropathy and paresthesias in his feet, for which he was treated with pregabalin. During the therapy, his eosinophil level was high (60.3%). Pregabalin was stopped, and after one month his differential eosinophil had dropped dramatically, to 7.3%. Based on the Naranjo Adverse Drug Reaction scale, it is probable that the eosinophilia was induced by pregabalin, as the Naranjo probability score was calculated to be 8.Background: Pregabalin, a structural derivative of the inhibitory neurotransmitter gamma amino butyric acid, has antiepileptic, analgesic, and anxiolytic properties; therefore, it is used for painful diabetic neuropathy, postherpetic neuralgia, fibromyalgia, and neuropathic pain associated with spinal-cord injury and as adjunctive therapy in refractory partial seizures. The common adverse side effects include somnolence, weight gain, dizziness, peripheral edema, abnormal constipation, thirst, and blurring of vision.Case report: This is a case report on a 77-year-old diabetic patient with peripheral neuropathy and paresthesias in his feet (with a nocturnal preponderance), for which he was treated with pregabalin. During the pregabalin therapy, his eosinophil level was high (60.3%). Pregabalin was stopped, and after one month his differential eosinophil had dropped dramatically, to 7.3%. Based on the Naranjo Adverse Drug Reaction scale, it is probable that the eosinophilia was induced by pregabalin, as the Naranjo probability score was calculated to be 8.Conclusion: The incidence of eosinophilia attributable to pregabalin is very rare and warranted discontinuation of the drug.","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4140/TCP.n.2018.317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36202769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Concerns for Bleeding in the Elderly with the Use of Direct Oral Anticoagulants. 直接口服抗凝剂对老年人出血的影响。

CONSULTANT PHARMACIST Pub Date : 2018-05-01 DOI: 10.4140/TCP.n.2018.262.

Michelle Min, Stephanie Sibicky

引用次数: 3

Management of Venous Thromboembolism in the Elderly: A Review of the Non-Vitamin K Oral Anticoagulants. 老年人静脉血栓栓塞的治疗:非维生素K口服抗凝剂的综述。

CONSULTANT PHARMACIST Pub Date : 2018-05-01 DOI: 10.4140/TCP.n.2018.248.

Laressa Bethishou, Tania Gregorian, Kimberly Won, Kristina Lopez, Laura V Tsu

{"title":"Management of Venous Thromboembolism in the Elderly: A Review of the Non-Vitamin K Oral Anticoagulants.","authors":"Laressa Bethishou, Tania Gregorian, Kimberly Won, Kristina Lopez, Laura V Tsu","doi":"10.4140/TCP.n.2018.248.","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.248.","url":null,"abstract":"Objective To provide an up-to-date review of the available evidence regarding pharmacotherapeutic management of venous thromboembolic events in the geriatric population. Data Sources A PubMed search of articles published through August 2017 was performed using a combination of the following words: apixaban, betrixaban, dabigatran, edoxaban, enoxaparin, geriatric, heparin, idaricizumab, rivaroxaban, and venous thromboembolism. Study Selection/data Extraction Relevant original research, review articles, and guidelines were assessed for the management of elderly patients with venous thromboembolism (VTE). References from the above literature were also evaluated. Articles were selected for inclusion based on relevance to the topic, detailed methods, and complete results. Data Synthesis VTE, which includes deep vein thrombosis and pulmonary embolism, is common in the geriatric population. Elderly patients are at high risk for VTE, but management is complicated by comorbidities and a higher risk of bleeding. Until recently, warfarin has been the mainstay of therapy. Newer oral anticoagulants, which include apixaban, dabigatran, edoxaban, and rivaroxaban are now available, but there is limited information on their safety and efficacy in the geriatric population. This article reviews the current literature regarding outcomes and summarizes pharmacotherapeutic management of VTE in the elderly population. Conclusion Appropriate management of pharmacotherapy for VTE can help improve outcomes in elderly patients, and pharmacists can provide guidance and education regarding evidence-based therapy.","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36121241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

The Impact of Cholinesterase Inhibitors with or without Memantine on Antipsychotic Prescribing. 胆碱酯酶抑制剂联合或不联合美金刚对抗精神病药物处方的影响。

CONSULTANT PHARMACIST Pub Date : 2018-05-01 DOI: 10.4140/TCP.n.2018.273.

Amie Taggart Blaszczyk, Belinda Hong Mang, Hennie Garza, Monica Mathys

{"title":"The Impact of Cholinesterase Inhibitors with or without Memantine on Antipsychotic Prescribing.","authors":"Amie Taggart Blaszczyk, Belinda Hong Mang, Hennie Garza, Monica Mathys","doi":"10.4140/TCP.n.2018.273.","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.273.","url":null,"abstract":"Background Alzheimer's disease (AD) medications have been suggested to positively affect behavior, though not universally in all studies. Their impact on antipsychotic use is not well-defined. Methods This cross-sectional, retrospective study evaluated residents with AD on cholinesterase inhibitors, memantine, both, or neither throughout multiple long-term care facilities during July 2014. Patients were included if they: were between 65 and 89 years of age, had a diagnosis of AD, and had a cognitive assessment within three months of the study period. Patients residing in the facility for 100 days or fewer, or those having a Centers for Medicare & Medicaid Services-approved diagnosis for antipsychotic use were excluded. The primary outcome was the prevalence of antipsychotic prescribing in patients receiving AD medications compared with those without AD therapy. The Texas Tech University Health Sciences Center institutional review board approved the study protocol. Results Of 1,282 patients screened, 285 (161 AD medications and 124 no-AD medications) were analyzed. Median cognitive status scores suggested severe cognitive impairment. Patients receiving AD medications had higher antipsychotic utilization compared with those without AD medications (27% vs. 19%, respectively; P = 0.08). Patients receiving combination AD medications had the highest antipsychotic use. No statistically significant differences were detected in cognitive status subgroups. Of interest is that a post-hoc analysis found a statistically significant association with greater antipsychotic use and increasing number of AD medications. Conclusion Long-term care facility residents with AD receiving AD medications had higher rates of antipsychotic use compared with those not receiving AD treatment. The link between antipsychotic use and the number of AD medications may point to overprescribing in dementia with behavioral disturbances as a potential contributing factor.","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36121244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Long-Term Care: The Thorniest Health Care Problem. 长期护理:最棘手的卫生保健问题。

CONSULTANT PHARMACIST Pub Date : 2018-05-01 DOI: 10.4140/TCP.n.2018.284.

Paul Baldwin

引用次数: 0

Long-Term Care: The Thorniest Health Care Problem 长期护理:最棘手的卫生保健问题

CONSULTANT PHARMACIST Pub Date : 2018-05-01 DOI: 10.4140/tcp.n.2018.284

P. Baldwin

引用次数: 0

Getting Paid for Clinical Services. 获得临床服务报酬。

CONSULTANT PHARMACIST Pub Date : 2018-05-01 DOI: 10.4140/TCP.n.2018.240.

Caren McHenry Martin

引用次数: 0

Pharmacist Impact on Tacrolimus Serum Concentrations in Liver Transplant Patients. 药师对肝移植患者他克莫司血清浓度的影响。

CONSULTANT PHARMACIST Pub Date : 2018-05-01 DOI: 10.4140/TCP.n.2018.268.

Michael J Schuh, Gabriella Massoglia

{"title":"Pharmacist Impact on Tacrolimus Serum Concentrations in Liver Transplant Patients.","authors":"Michael J Schuh, Gabriella Massoglia","doi":"10.4140/TCP.n.2018.268.","DOIUrl":"https://doi.org/10.4140/TCP.n.2018.268.","url":null,"abstract":"Objective The purpose of this quality-improvement project was to determine if a pharmacist consultation following a liver transplant is associated with an increased percentage of drug levels in range after the patient sees the pharmacist. Setting Tertiary care, multispecialty medical clinic, and hospital providing solid-organ transplant. Practice Description Pharmacist consult service in a tertiary care, multispecialty medical clinic and hospital providing solid-organ transplant. Practice InnovationProvision of liver post-transplant consultations, not required by the Centers for Medicare & Medicaid Services, that results in therapeutic drug level improvement. Main Outcome MeasureTacrolimus therapeutic drug levels in range. Results A 96% improvement in quantity of therapeutic tacrolimus levels was seen in liver post-transplant patients after pharmacist post-transplant consultation. Results revealed 59 out of 74 (79.7%) post-liver transplant patients, 25 to 77 years of age (average 59.7 years), had an increased number of therapeutic tacrolimus levels after pharmacist post-transplant consultation. ConclusionWithout a pharmacist consultation following a liver transplant, patients may have a higher number of tacrolimus levels out of therapeutic range, placing them at increased risk for possible graft loss from low tacrolimus levels or toxicity resulting from high tacrolimus levels. Improvement in therapeutic tacrolimus levels after liver transplant was observed after patients received consultation and education from a clinical pharmacist. This finding creates an opportunity for pharmacists to implement services for patients after liver transplants to improve therapeutic tacrolimus levels.","PeriodicalId":45985,"journal":{"name":"CONSULTANT PHARMACIST","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36121243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Shifting Paradigms in Caring for Older Adults. 照顾老年人的转变模式。

CONSULTANT PHARMACIST Pub Date : 2018-05-01 DOI: 10.4140/TCP.n.2018.230.

H Edward Davidson

引用次数: 0

Considerations for Geriatric Patients with COPD. 老年COPD患者的注意事项。

CONSULTANT PHARMACIST Pub Date : 2018-04-01 DOI: 10.4140/TCP.n.2018.210

Nikki Neumann, Paige Odegard, Michael Swanoski

引用次数: 1