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Despite the advances in diabetes management, people with diabetes are not reaching their target glycemic goals. Healthcare professionals often fail to initiate, escalate, or de-intensify therapy when indicated. There are several organizations that provide guidance on the management of diabetes to assist the practitioner in achieving improved glycemic control, and this can cause confusion to the practitioner on which organizations' guidance to follow. Diabetes mellitus is associated with an elevated risk of cardiovascular disease, and there have been studies that suggest some antidiabetic medications increase cardiovascular risk and some reduce cardiovascular risk. Diabetes organizations recommend the individualization of treatment goals and choices of drug therapy that will be safe and effective. Healthcare professionals should be knowledgeable and equipped to decide on the best treatment regimen for each of their patients with type 2 diabetes (T2D) and be familiar with how to utilize the different organizations' philosophies in treating their patients.
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Bezlotoxumab (Zinplava) to prevent the recurrence of Clostridium difficile infection.
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BACKGROUND Dietary supplements have been associated with an increase in emergency intervention as a result of unexpected adverse events. Limited resources and information on significant drug-drug interactions with dietary supplements and prescription medications have contributed to associated complications and unexpected events. We present the case of a patient who consumed multiple prescription medications and dietary supplements which resulted in significant complications. CASE REPORT A 28-year-old man presented to the Emergency Department complaining of severe calf pain after exercising. In addition to his prescription medications, which included sertraline, he also consumed dietary supplements prior to his workout. He developed serotonin syndrome with rhabdomyolysis, which rapidly progressed to acute compartment syndrome. An emergency bilateral four-compartment double-incision lower extremity and forearm fasciotomy was performed, with complete recovery. CONCLUSIONS Drug-drug interactions involving dietary supplements are frequently overlooked in most healthcare settings, especially in the Emergency Department. Health care providers should be cognizant of the potential drug- drug interactions resulting in serotonin syndrome to prevent the progression to acute compartment syndrome and associated complications. Pharmacists play a key role in recognizing drug-dietary supplement interactions and adverse effects.
Subject(s)
Compartment Syndromes/etiology , Dietary Supplements/adverse effects , Selective Serotonin Reuptake Inhibitors/adverse effects , Serotonin Syndrome/chemically induced , Adult , Compartment Syndromes/surgery , Drug Interactions , Fasciotomy , Humans , Male , Sertraline/adverse effectsABSTRACT
Daclatasvir (Daklinza) for chronic hepatitis C infection.
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OBJECTIVE: The objectives of this study were to (1) examine the relationships between Emotional Thinking Scale (ETS) scores and demographic variables such as income, years worked as a pharmacist, and hours worked per week and (2) determine the distribution of ETS scores among this sample of pharmacists. These objectives are significant to explore because they may provide important data regarding effective and ineffective pharmacist work-related behaviors that affect career and life success. METHOD: A convenience sample of practicing pharmacists was selected. Participants completed the 8-item ETS and a demographic survey. The ETS predicts how an individual's thoughts might influence his or her emotions and behaviors. Researchers analyzed participant's ETS scores with his or her demographic responses. Data were analyzed using SPSS statistical software. RESULTS: One hundred twenty-five pharmacists completed the survey. Twenty-one percent of the sample scored between slightly high and very extremely high on the ETS. "often being incapacitated by strong feelings" correlated negatively with annual income r = -.309 (P = .008); "relying on feelings to deal with complex situations" correlated negatively with annual income r = -.253 (P = .026), with the "number of years practicing pharmacy" r = -.317 (P = .007), and "number of hours worked each week" r = -.317 (P = .007); and "focusing on details thus losing the big picture" was correlated negatively with annual income r = .215 (P = .05). These findings are consistent with the previous ETS research. CONCLUSION: The variables of interest in this study were negatively but significantly related. Emotional thinking scores decreased with pharmacy practice experience and may be counterproductive for career goals. Entry-level pharmacy education and continuing education programs may help develop self-awareness to this issue.
Subject(s)
Career Mobility , Emotions , Goals , Pharmacists/psychology , Adult , Aged , Female , Humans , Job Satisfaction , Male , Middle Aged , Surveys and Questionnaires , ThinkingABSTRACT
Ceftolozane/tazobactam: a new option in the treatment of complicated gram-negative infections.
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Glucarpidase (Voraxaze) for methotrexate toxicity.
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BACKGROUND: Dexlansoprazole, the dextrorotatory enantiomer of lansoprazole, is a proton pump inhibitor (PPI) formulated to have dual delayed-release properties. It is indicated for healing all grades of esophagitis, maintaining the healing of erosive esophagitis (EE), and treating heartburn associated with nonerosive gastroesophageal reflux disease. OBJECTIVE: This article reviews the pharmacology, pharmacokinetics, and pharmacodynamics of dexlansoprazole, as well as its clinical efficacy and tolerability. METHODS: MEDLINE (1966-April 2010) and International Pharmaceutical Abstracts (1970-April 2010) were searched for original research and review articles published in English using the terms dexlansoprazole and TAK-390MR. The reference lists of identified articles were reviewed for additional pertinent publications. Abstracts from 2007-2009 American College of Gastroenterology and Digestive Disease Week meetings were searched using the same terms. RESULTS: By irreversibly binding to H(+)K(+)-ATPase, dexlansoprazole inhibits acid production by the parietal cell. Its dual delayed-release formulation provides 2 distinct releases of medication, prolonging the mean residence time compared with lansoprazole (5.56-6.43 vs 2.83-3.23 hours, respectively). In 2 identical Phase III trials of the healing of EE, there were no significant differences in rates of complete healing after 8 weeks between dexlansoprazole 60 and 90 mg once daily and lansoprazole 30 mg once daily. In 2 studies of the maintenance of healing of EE, rates of healing at 6 months were significantly higher with dexlansoprazole 30, 60, and 90 mg once daily compared with placebo (P < 0.001). Patients with nonerosive reflux disease who received dexlansoprazole 30 or 60 mg once daily had significantly more 24-hour heartburn-free days compared with those who received placebo (P < 0.001). Dexlansoprazole was well tolerated compared with placebo or lansoprazole in all studies. CONCLUSIONS: In the studies reviewed, dexlansoprazole was well tolerated and effective in the healing and maintenance of EE, and in the treatment of nonerosive reflux disease. However, most of the available evidence involved comparisons with placebo, making it difficult to draw meaningful conclusions about the place of dexlansoprazole among PPIs. More head-to-head comparative trials with other PPIs are needed to determine whether the unique formulation of dexlansoprazole translates into a clinically meaningful improvement in outcomes.
