5,224 results match your criteria Pharmacotherapy[Journal]


Contemporary Management of Direct Oral Anticoagulants During Cardioversion and Ablation for Nonvalvular Atrial Fibrillation.

Pharmacotherapy 2018 Dec 12. Epub 2018 Dec 12.

Professor of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee.

Introduction: As overall prevalence of atrial fibrillation (AF) continues to rise, the number of patients who undergo ablation, or electrical/chemical cardioversion, to restore normal sinus rhythm continues to increase as well. As direct oral anticoagulants (DOACs) have continued to be incorporated into clinical practice for long-term anticoagulation for AF, experience with how best to manage use of DOACs during electrophysiologic procedures is evolving.

Objective: This review is intended to provide health care providers with a summary of current evidence regarding the use of DOACs during cardioversion and catheter ablation and provide key considerations for their use during such electrophysiologic procedures. Read More

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December 2018

TLR9 rs352139 genetic variant promotes tacrolimus elimination in Chinese liver transplant patients during the early posttransplantation period.

Pharmacotherapy 2018 Dec 8. Epub 2018 Dec 8.

Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.

Background: There are limited markers that could facilitate individualized tacrolimus treatment in the early posttransplantation period. Genetic factors have been found to play critical roles in determining tacrolimus pharmacokinetics.

Objective: We aimed to examine the association of donor and recipient Toll-like receptor (TLR) polymorphisms with tacrolimus elimination and the potential mechanism for TLR gene polymorphism-mediated tacrolimus metabolism. Read More

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December 2018

Patient-level medication regimen complexity in an adolescent and adult population with autism spectrum disorders.

Pharmacotherapy 2018 Dec 3. Epub 2018 Dec 3.

The Ohio State University, Center for Biostatistics, 320-43 Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210.

Background: Adults with autism spectrum disorder (ASD) frequently experience polypharmacy. However, there is limited understanding of how to quantify medication complexity in this vulnerable population.

Objective: This study examined medication administration difficulty using the Medication Regimen Complexity Index (MRCI) tool in adolescents and adults with ASD. Read More

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December 2018
2.662 Impact Factor

Prevention of Clostridium difficile Infection in Critically Ill Adults.

Pharmacotherapy 2018 Dec 3. Epub 2018 Dec 3.

Department of Pharmacy, Mayo Clinic, Rochester, MN.

The incidence and severity of Clostridium difficile infection (CDI) remain high across intensive care units in the United States despite national efforts to decrease this escalating health care burden. Most published literature and guidelines address treatment rather than prevention, yet this approach may be too downstream to limit morbidity and mortality from the disease and its complications. Mechanisms to successfully prevent CDI include reducing modifiable risk factors and minimizing horizontal transmission of C. Read More

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December 2018
1 Read

Duration of Exposure to Antipseudomonal β-Lactam Antibiotics in the Critically Ill and Development of New Resistance.

Pharmacotherapy 2018 Dec 3. Epub 2018 Dec 3.

Department of Pharmacy Practice, St. Louis College of Pharmacy, St. Louis, MO, USA.

Study Objective: Minimizing the duration of broad-spectrum antimicrobial exposure in the critically ill is a commonly used strategy aimed at preventing resistance. Our objective was to correlate the duration of exposure to antipseudomonal β-lactam antibiotics with the development of new resistance in critically ill patients.

Design: Single-center, retrospective cohort study. Read More

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December 2018
1 Read

Catecholamine Vasopressor Support Sparing Strategies in Vasodilatory Shock.

Pharmacotherapy 2018 Dec 1. Epub 2018 Dec 1.

Department of Pharmacy Practice, University of Pittsburgh School of Pharmacy, Pittsburgh, PA.

Shock syndromes are associated with unacceptably high rates of mortality in critically ill patients despite advances in therapeutic options. Vasodilatory shock is the most common type encountered in the intensive care unit. It is manifested by cardiovascular failure, peripheral vasodilatation, and arterial hypotension leading to tissue hypoperfusion and organ failure. Read More

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December 2018
1 Read

Plazomicin, a Next-Generation Aminoglycoside.

Pharmacotherapy 2018 Dec 4. Epub 2018 Dec 4.

The University of Texas at Tyler Ben and Maytee Fisch College of Pharmacy, Tyler, TX.

Plazomicin is a novel aminoglycoside antibiotic that binds to the bacterial 30S ribosomal subunit, thus inhibiting protein synthesis via a concentration-dependent manner. Plazomicin displays a broad spectrum of activity against aerobic gram-negative bacteria, including extended-spectrum β-lactamase-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, and organisms with aminoglycoside-modifying enzymes. In a large phase III clinical trial, plazomicin was shown to be noninferior to meropenem in the treatment of complicated urinary tract infections (cUTI) with respect to the coprimary efficacy endpoints of the microbiologically modified intent-to-treat composite cure rate at day 5 (plazomicin 88% [n=168/191] vs meropenem 91. Read More

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December 2018
3 Reads

A Rare Case of Levetiracetam and Drug-Induced Idiopathic Aseptic Meningitis in a Pediatric Patient.

Pharmacotherapy 2018 Nov 29. Epub 2018 Nov 29.

Hovnanian Children's Hospital at Hackensack Meridian Health, Hackensack, New Jersey.

Levetiracetam (LEV) is a pyrrolidine derivative antiepileptic medication used for the treatment of seizures in pediatric and adult patients. We report a case of probable LEV-induced aseptic meningitis in a 13-year-old girl. The patient received LEV for a generalized seizure disorder and presented with symptoms 5 days after medication initiation. Read More

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November 2018
1 Read

Discontinuation and Nonadherence to Medications for Chronic Conditions after Hematopoietic Cell Transplantation: A Six-Year Propensity Score-Matched Cohort Study.

Pharmacotherapy 2018 Nov 28. Epub 2018 Nov 28.

Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, Illinois, United States.

Introduction: Hematopoietic cell transplantation (HCT) is an established curative option for patients with hematological malignancies and other life-threatening conditions. Evidence on nonpersistence and nonadherence to oral medications for chronic conditions among patients following HCT is lacking.

Objectives: This study aims to examine patterns of oral medication use for chronic conditions following HCT in the United States population. Read More

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November 2018

Abacavir Hypersensitivity Reaction Reporting Rates During a Decade of HLA-B*5701 Screening as a Risk-Mitigation Measure.

Pharmacotherapy 2018 Nov 10. Epub 2018 Nov 10.

Global Medical Sciences, ViiV Healthcare, Research Triangle Park, North Carolina.

Introduction: Human leukocyte antigen (HLA)-B*5701 screening identifies patients at increased risk for abacavir (ABC) hypersensitivity reaction (HSR). Screening was adopted in GlaxoSmithKline and ViiV Healthcare clinical trials in 2007 and human immunodeficiency virus treatment guidelines in 2008. Company meta-analyses of trials pre-HLA-B*5701 screening reported HSR rates of 4-8%. Read More

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November 2018
10 Reads

Reappraisal of Contemporary Pharmacokinetic and Pharmacodynamic Principles for Informing Aminoglycoside Dosing.

Pharmacotherapy 2018 Dec;38(12):1229-1238

Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, New York.

Therapeutic drug management is regularly performed for aminoglycosides in an effort to maximize their effectiveness and safety. The ratio of maximum plasma drug concentration to minimum inhibitory concentration (Cmax/MIC) has long been regarded as the primary pharmacokinetic/pharmacodynamic (PK/PD) index of clinical efficacy for aminoglycosides due to their concentration-dependent killing. In this review, however, we discuss why the area under the plasma concentration-time curve (AUC)/MIC ratio may be a more reliable indicator of bacterial killing and clinical efficacy for these agents. Read More

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December 2018
3 Reads

Adjunctive Use of Cidofovir and Intravenous Immunoglobulin to Treat Invasive Adenoviral Disease in Solid Organ Transplant Recipients.

Pharmacotherapy 2018 Dec 26;38(12):1260-1266. Epub 2018 Nov 26.

Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Background: Infections with adenoviruses (ADVs) can result in considerable mortality and morbidity in solid organ transplant (SOT) recipients. Standard therapy for ADV infections in transplant recipients is not established. At our institution, intravenous cidofovir and immunoglobulin have been used to treat disseminated or invasive ADV in SOT and hematopoietic stem cell transplant recipients. Read More

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December 2018
3 Reads

Cohort Study of Albumin versus Lactated Ringer's for Postoperative Cardiac Surgery Fluid Resuscitation in the Intensive Care Unit.

Pharmacotherapy 2018 Dec;38(12):1241-1249

Anesthesiology & Perioperative Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.

Purpose: A new postcardiac surgery fluid resuscitation strategy was implemented in our cardiovascular intensive care unit (CVICU) to implement evidence-based practice. We transitioned from a primarily albumin fluid-based strategy to a lactated Ringer's fluid-based strategy. We sought to determine whether a new postoperative fluid resuscitation strategy significantly altered the fluid composition for postcardiac surgery patients and what effect that would have on fluid resuscitation costs. Read More

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December 2018
1 Read

Impact of Central Nervous System Stimulant Medication Use on Growth in Pediatric Populations with Attention-Deficit/Hyperactivity Disorder: A Review.

Pharmacotherapy 2018 Oct 28. Epub 2018 Oct 28.

University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado.

Central nervous system stimulants are a commonly used first-line treatment option for attention-deficit/hyperactivity disorder (ADHD). Stimulants are generally well tolerated, with anorexia and insomnia the most common adverse effects. However, there are some concerns with long-term use of stimulants, such as potential growth delay. Read More

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October 2018
6 Reads

Review and Validation of Bayesian Dose-Optimizing Software and Equations for Calculation of the Vancomycin Area Under the Curve in Critically Ill Patients.

Pharmacotherapy 2018 Dec 23;38(12):1174-1183. Epub 2018 Nov 23.

School of Pharmacy, Pacific University, Hillsboro, Oregon.

Background: Vancomycin area under the concentration-time curve (AUC) has been linked to efficacy and safety. An accurate method of calculating the AUC is needed.

Methods: Bayesian dose-optimizing software programs available for clinician use and first-order pharmacokinetic equations were evaluated for their ability to estimate vancomycin AUC. Read More

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December 2018

Drug Regimen Individualization for Attention-Deficit/Hyperactivity Disorder: Guidance for Methylphenidate and Dexmethylphenidate Formulations.

Pharmacotherapy 2018 Oct 23. Epub 2018 Oct 23.

Department of Pharmaceutical Sciences, University of Tennessee Health Sciences Center, College of Pharmacy, Memphis, Tennessee.

In 2000, the first biphasic modified-release (MR) formulation of methylphenidate (MPH) was approved for the treatment of attention-deficit/hyperactivity disorder (ADHD). An immediate-release (IR) MPH pulse (22% of the dose) facilitates rapid onset of stimulant action, while the remaining MR portion of the dose provides for day-long duration of efficacy. A wide array of oral MR-MPH products has subsequently been approved that also allows for once-daily dosing, though each product is characterized by distinctive exposure time courses. Read More

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October 2018
1 Read

Intravenous Lidocaine for Acute Pain: A Systematic Review.

Pharmacotherapy 2018 Dec 9;38(12):1250-1259. Epub 2018 Nov 9.

Loyola University Medical Center, Maywood, Illinois.

This systematic review evaluates the safety and efficacy of intravenous (IV) lidocaine for the treatment of acute pain in adult patients. The PubMed database was searched for randomized controlled trials, retrospective cohort studies, case series, and case reports evaluating the use of IV lidocaine for the treatment of acute pain in adult patients, published between January 1970 and January 2018. The primary outcome was pain reduction via the Visual Analog Scale, Verbal Rating Scale, or Numeric Rating Scale among patients treated with IV lidocaine and placebo or active controls. Read More

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December 2018
10 Reads

Population Pharmacokinetics of Gentamicin in Neonates with Hypoxemic-Ischemic Encephalopathy Receiving Controlled Hypothermia.

Pharmacotherapy 2018 Nov 24;38(11):1120-1129. Epub 2018 Oct 24.

St. Christopher's Hospital for Children, Philadelphia, Pennsylvania.

Objective: Identify population pharmacokinetics and pharmacodynamic target attainment of gentamicin in neonates with hypoxic-ischemic encephalopathy (HIE) undergoing controlled hypothermia (CH).

Design: Prospective open-label pharmacokinetic study. Gentamicin concentrations were modeled and dosing regimens simulated for a 5000-patient neonatal population with HIE receiving CH using PMetrics, a nonparametric, pharmacometric modeling, and simulation package for R. Read More

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November 2018
1 Read

Clinical Utility of Methicillin-Resistant Staphylococcus aureus Nasal Screening for Antimicrobial Stewardship: A Review of Current Literature.

Pharmacotherapy 2018 Dec 29;38(12):1216-1228. Epub 2018 Oct 29.

Department of Pharmacy, Seton Healthcare Family, Dell Seton Medical Center at The University of Texas, Austin, Texas.

Significant clinical and financial consequences are associated with both inadequate and unnecessary exposure to broad-spectrum antibiotics. As such, antimicrobial stewardship programs seek objective, reliable, and cost-effective tests to identify patients at highest or lowest risk for drug-resistant organisms to guide empirical antimicrobial selection. Use of methicillin-resistant Staphylococcus aureus (MRSA) nasal screening to rule out MRSA in lower respiratory tract infections has led to significant reductions in duration of vancomycin therapy. Read More

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December 2018
2 Reads
2.662 Impact Factor

Pharmacokinetics of the Meropenem Component of Meropenem-Vaborbactam in the Treatment of KPC-Producing Klebsiella pneumoniae Bloodstream Infection in a Pediatric Patient.

Pharmacotherapy 2018 Dec 9;38(12):e87-e91. Epub 2018 Nov 9.

St. Christopher's Hospital for Children, Philadelphia, Pennsylvania.

Meropenem-vaborbactam is a new β-lactam/β-lactamase inhibitor combination designed to target Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae. Meropenem-vaborbactam was United States Food and Drug Administration-approved for complicated urinary tract infections in patients 18 years of age or older. An understanding of the pharmacokinetics of meropenem when given in combination with vaborbactam is important to understanding the dosing of meropenem-vaborbactam. Read More

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December 2018
6 Reads

Omadacycline Enters the Ring: A New Antimicrobial Contender.

Pharmacotherapy 2018 Dec 15;38(12):1194-1204. Epub 2018 Nov 15.

Department of Pharmacy Practice, University of Mississippi School of Pharmacy, Jackson, Mississippi.

Omadacycline is a novel aminomethylcycline approved for the treatment of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections. This article reviews existing data pertaining to the biochemistry, mechanism of action, pharmacokinetics/pharmacodynamics, in vitro activity, and current progress with omadacycline in clinical trials. Omadacycline inhibits protein synthesis by binding to the 30S subunit of the bacterial ribosome at the tetracycline-binding site with an affinity similar to glycylcyclines. Read More

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December 2018
3 Reads

Suboptimal Clinical Response Rates with Newer Antibiotics Among Patients with Moderate Renal Impairment: Review of the Literature and Potential Pharmacokinetic and Pharmacodynamic Considerations for Observed Findings.

Pharmacotherapy 2018 Dec 9;38(12):1205-1215. Epub 2018 Nov 9.

Albany College of Pharmacy and Health Sciences, Albany, New York.

A number of antibacterial agents have emerged into the U.S. market in the last 2 decades to address growing concerns of antimicrobial resistance. Read More

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December 2018
4 Reads

Efficacy and Safety of Lesinurad in Patients with Hyperuricemia Associated with Gout: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Pharmacotherapy 2018 Nov 17;38(11):1106-1119. Epub 2018 Oct 17.

Center for Evidence-Based Health Care, Department of Medical Research, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan.

Objective: To evaluate the efficacy and safety of lesinurad for the treatment of hyperuricemia in patients with gout.

Design: Systematic review and meta-analysis of randomized controlled trials (RCTs).

Patients Or Participants: Five RCTs, which included 1959 patients, compared the efficacy and safety of lesinurad in patients with hyperuricemia associated with gout. Read More

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November 2018
2 Reads

Accuracy of Point-of-Care Blood Glucose Level Measurements in Critically Ill Patients with Sepsis Receiving High-Dose Intravenous Vitamin C.

Pharmacotherapy 2018 Nov 16;38(11):1155-1161. Epub 2018 Oct 16.

Department of Pharmacy, Maine Medical Center, Portland, Maine.

Study Objective: High-dose intravenous vitamin C is a potential treatment option for patients with sepsis and may interfere with point-of-care (POC) blood glucose (BG) testing. This study aimed to determine if vitamin C dosing used for sepsis affected POC BG level results.

Design: Prospective observational pilot study. Read More

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November 2018
2 Reads
2.660 Impact Factor

Comparative Effectiveness of Combination Therapy with Statins and Angiotensin-Converting Enzyme Inhibitors versus Angiotensin II Receptor Blockers in Patients with Coronary Heart Disease: A Nationwide Population-Based Cohort Study in Korea.

Pharmacotherapy 2018 Nov 21;38(11):1095-1105. Epub 2018 Oct 21.

College of Pharmacy, Ajou University, Suwon, South Korea.

Study Objective: Patients with coronary heart disease (CHD) frequently use the combination of a statin and renin-angiotensin-aldosterone system (RAAS) blocker, an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB), to control lipid levels and blood pressure, respectively, and the use of ARBs is increasing in Korean patients. Few studies are available, however, that have compared combination therapy with statin-ACEIs versus statin-ARBs. The objective of this study was to evaluate whether ARBs are associated with a reduced risk of major adverse cardiovascular and cerebrovascular events (MACCEs) compared with ACEIs when used in combination with statins in patients with established CHD. Read More

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November 2018
2 Reads

New Food and Drug Administration-Approved and Emerging Novel Treatment Options for Acute Myeloid Leukemia.

Pharmacotherapy 2018 Nov 17;38(11):1143-1154. Epub 2018 Oct 17.

Memorial Sloan Kettering, New York, New York.

Advancements in the treatment of acute myeloid leukemia (AML) have been sparse during the past several decades, and the disease continues to have a poor prognosis. However, in 2017 alone, four new medications approved by the U.S. Read More

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November 2018
1 Read

Incidence of Acute Kidney Injury Among Patients Receiving the Combination of Vancomycin with Piperacillin-Tazobactam or Meropenem.

Pharmacotherapy 2018 Dec 3;38(12):1184-1193. Epub 2018 Oct 3.

Department of Pharmacy Practice, University of Arkansas for Medical Sciences Northwest Regional Campus, Fayetteville, Arkansas.

Introduction: Vancomycin (VAN) is associated with an increased risk of acute kidney injury (AKI). Evidence is conflicting regarding the risk of AKI when VAN is combined with an antipseudomonal β-lactam.

Objectives: To determine the comparative incidence of AKI when VAN is combined with piperacillin-tazobactam (PTZ) or meropenem (MER). Read More

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December 2018
7 Reads

Investigating the Potential for Bias When Using a Widely Accepted Medication Adherence Measure to Predict Mortality.

Pharmacotherapy 2018 Nov 19;38(11):1086-1094. Epub 2018 Sep 19.

Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson VAMC, Charleston, South Carolina.

Study Objective: Summary measures of medication adherence, such as the proportion of days covered (PDC), are often used to analyze the association between medication adherence and various health outcomes. We hypothesized that PDC and similar measures may lead to biased results in some situations when used to estimate the association between adherence and the outcome event (e.g. Read More

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November 2018
1 Read

An Overview of Hyperinsulinemic-Euglycemic Therapy in Calcium Channel Blocker and β-blocker Overdose.

Pharmacotherapy 2018 Nov 4;38(11):1130-1142. Epub 2018 Oct 4.

Purdue University College of Pharmacy, West Lafayette, Indiana.

Both calcium channel blockers (CCBs) and β blockers (BBs) are associated with fatal substance exposures within the United States. Cases of overdose with these agents have the potential to be both complex and difficult to manage. A variety of pharmacologic treatment options are available for clinicians to use to help mitigate harm from these poisonings. Read More

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November 2018
2 Reads

Increased Enoxaparin Dosing Requirements for Treatment of Deep Vein Thrombosis in a Severely Burned Patient: Case Report and Literature Review.

Pharmacotherapy 2018 Nov 16;38(11):e82-e86. Epub 2018 Sep 16.

Detroit Medical Center, Detroit Receiving Hospital, Detroit, Michigan.

Dosing of enoxaparin for deep vein thrombosis (DVT) prophylaxis in acutely burned patients has been shown to result in anti-Xa levels below target range. We describe the first case report, to our knowledge, of a severely burned patient who, despite prophylactic dosing of enoxaparin 30 mg subcutaneously twice daily, developed an acute DVT that required high-dose enoxaparin (100 mg [1.5 mg/kg] subcutaneously every 8 hours) to maintain anti-Xa levels within the therapeutic range (0. Read More

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November 2018
1 Read

Current and Investigational Agents Targeting the Phosphoinositide 3-Kinase Pathway.

Pharmacotherapy 2018 Oct 25;38(10):1058-1067. Epub 2018 Sep 25.

Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York.

Prevalent molecular alterations of the phosphoinositide 3-kinase (PI3K) pathway are found on solid tumors and are expressed in leukocytes, making it a desirable target in both solid and hematologic malignancies. In recent years, two agents targeting this pathway have been approved by the United States Food and Drug Administration, idelalisib and copanlisib, with many others under investigation. Due to the off-target effects seen with these agents, those under development have varying isoform specificity that mitigates toxicity. Read More

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October 2018
3 Reads

Impact of Serum Cystatin C-Based Glomerular Filtration Rate Estimates on Drug Dose Selection in Hospitalized Patients.

Pharmacotherapy 2018 Oct 12;38(10):1068-1073. Epub 2018 Sep 12.

Department of Pharmacy, Mayo Clinic, Rochester, Minnesota.

Study Objective: Serum creatinine (S ) concentration is used to calculate estimated glomerular filtration rate (eGFR) for medication dosing. Serum cystatin C (CysC) concentration has been proposed as an adjunct or alternative to S . This study sought to evaluate the possible impact of using CysC in eGFR equations on drug dose recommendations in hospitalized patients with infections. Read More

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October 2018
2 Reads

Tenofovir Alafenamide for the Treatment of Chronic Hepatitis B Monoinfection.

Pharmacotherapy 2018 Oct 9;38(10):1051-1057. Epub 2018 Sep 9.

University of Florida College of Pharmacy, Orlando, Florida.

Tenofovir alafenamide (TAF) is indicated for adult patients with chronic hepatitis B virus (HBV) infection with compensated liver disease at an oral dose of 25 mg/day. TAF is a more stable prodrug in the plasma than tenofovir disoproxil fumarate (TDF), leading to decreased plasma exposure of tenofovir. Decreased exposure is thought to reduce the risk of long-term TDF toxicities, such as nephrotoxicity and decreased bone mineral density (BMD). Read More

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October 2018
1 Read

Re-evaluating the Utility of Stress Ulcer Prophylaxis in the Critically Ill Patient: A Clinical Scenario-Based Meta-Analysis.

Pharmacotherapy 2018 Aug 13. Epub 2018 Aug 13.

University of Colorado Skaggs School of Pharmacy, Aurora, Colorado.

Study Objective: Because recent studies have challenged the efficacy of stress ulcer prophylaxis (SUP) in the critically ill patient, our objective was to evaluate the efficacy of SUP with proton pump inhibitors (PPIs) or histamine -receptor antagonists (H RAs) against placebo, control, no therapy, or enteral nutrition alone in critically ill adults.

Design: Meta-analysis with trial sequential analysis (TSA) of 34 randomized controlled trials.

Patients: A total of 3220 critically ill adults who received PPIs or H RAs versus placebo, control, no therapy, or enteral nutrition. Read More

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August 2018
1 Read

A Multicenter, Prospective, Observational Study to Determine Predictive Factors for Multidrug-Resistant Pneumonia in Critically Ill Adults: The DEFINE Study.

Pharmacotherapy 2018 Aug 12. Epub 2018 Aug 12.

University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Objective: This study was conducted to describe the prevalence, epidemiology, and clinical outcomes of multidrug-resistant (MDR) organism (MDRO) pneumonia in critically ill patients.

Methods: A multicenter, prospective, observational study of patients admitted to 60 intensive care units (ICUs), from 34 hospitals, in the United States from November to December 2016. Adults (> 18 yrs) receiving antimicrobial therapy at least 5 days for pneumonia were included. Read More

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August 2018
11 Reads
2.662 Impact Factor

Association between Development of Dementia and Use of Benzodiazepines: A Systematic Review and Meta-Analysis.

Pharmacotherapy 2018 Oct 6;38(10):1010-1020. Epub 2018 Sep 6.

Drugs and Medicine, Universidade Julio de Mesquita Filho - Unesp, Araraquara, São Paulo, Brazil.

Study Objective: The use of benzodiazepines and the development of dementia is controversial, with studies indicating that benzodiazepines could be either a protective factor or a risk factor for dementia, or no association may exist between the two. Our objective was to identify whether such an association exists.

Design: Systematic review and meta-analysis of 12 prospective and retrospective cohort studies and case-control studies. Read More

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October 2018
2 Reads

Intranasal Lidocaine for Acute Management of Primary Headaches: A Systematic Review.

Pharmacotherapy 2018 Oct;38(10):1038-1050

Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Intranasal lidocaine has been studied and recommended as an alternative in the management of acute headache. The objective of this systematic review was to evaluate the efficacy and safety of intranasal lidocaine in the acute management of primary headaches. The MEDLINE (1946 to May 2018), EMBASE (1974 to May 2018), Cochrane Central Register of Controlled Trials (2008 to May 2018), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to May 2018), and ClincialTrials. Read More

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October 2018
4 Reads

Risks of Major Long-Term Side Effects Associated with Androgen-Deprivation Therapy in Men with Prostate Cancer.

Pharmacotherapy 2018 Oct 4;38(10):999-1009. Epub 2018 Sep 4.

Department of Epidemiology, Human Genetics, and Environmental Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas.

Study Objective: To examine the risks and compare the occurrences of major long-term side effects (sexual dysfunction, bone fractures, diabetes, cardiovascular morbidity, acute myocardial infarction [MI], and dementia) in patients with prostate cancer who received androgen-deprivation therapy (ADT) with those who did not.

Design: Propensity score-matched retrospective cohort study using Medicare claims data.

Data Source: National Cancer Institute's Surveillance, Epidemiology, and End Results Program-Medicare linked database. Read More

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October 2018
9 Reads

FDA Breakthrough Therapy Designation: Evaluating the Quality of the Evidence behind the Drug Approvals.

Pharmacotherapy 2018 Sep;38(9):967-980

Department of Pharmacy Practice, Oregon State University/Oregon Health & Science University College of Pharmacy, Corvallis, Oregon.

The United States Food and Drug Administration (FDA) has created approval pathways and designations to accelerate access to medications indicated for serious or life-threatening conditions with limited treatment options. Implemented in 2012, the most recent of these is the breakthrough therapy designation (BTD). The purpose of this article was to review the evidence surrounding approval of medications with nononcology indications approved with the BTD designation from 2012 to 2016. Read More

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September 2018
1 Read

Innovations in Medication Safety: Services and Technologies to Enhance the Understanding and Prevention of Adverse Drug Reactions.

Pharmacotherapy 2018 Aug 22;38(8):782-784. Epub 2018 Jul 22.

Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.

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August 2018
1 Read

Lefamulin: Review of a Promising Novel Pleuromutilin Antibiotic.

Pharmacotherapy 2018 Sep 20;38(9):935-946. Epub 2018 Aug 20.

Department of Pharmacy Practice, University of Mississippi, Jackson, Mississippi.

The emergence and spread of antimicrobial resistance have led to a global public health emergency requiring development of new antimicrobial classes. Lefamulin (formally BC-3781) is a novel pleuromutilin antibiotic currently undergoing Food and Drug Administration review for community-acquired bacterial pneumonia (CABP) as intravenous (IV) and oral (PO) formulations. Although pleuromutilin antibiotics were first developed in the 1950s, lefamulin is the first to be used for systemic treatment of bacterial infections in humans. Read More

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September 2018
31 Reads

Time Course and Extent of Renal Function Changes in Patients Receiving Treatment for Staphylococcal Pneumonias: An Analysis Comparing Telavancin and Vancomycin from the ATTAIN Trials.

Pharmacotherapy 2018 Oct 29;38(10):990-998. Epub 2018 Aug 29.

Vanderbilt University School of Medicine, Nashville, Tennessee.

Study Objective: Telavancin and vancomycin are both approved for treatment of hospital-acquired and ventilator-associated bacterial pneumonias caused by Staphylococcus aureus, and both agents can cause renal dysfunction. The objective of this study was to assess renal function changes by performing renal shift table analyses of telavancin- and vancomycin-treated patients in phase III trials.

Design: Retrospective, descriptive analysis of data from the safety population from the Assessment of Telavancin for Treatment of Hospital-Acquired Pneumonia (ATTAIN) trials. Read More

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October 2018
8 Reads

Management of Pediatric Acute Hematogenous Osteomyelitis, Part II: A Focus on Methicillin-Resistant Staphylococcus aureus, Current and Emerging Therapies.

Pharmacotherapy 2018 Oct 4;38(10):1021-1037. Epub 2018 Sep 4.

Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut.

Methicillin-resistant Staphylococcus aureus (MRSA) has become the most prevalent cause of acute hematogenous osteomyelitis (AHO) in pediatric patients. This increase in MRSA is due to the rise in community-acquired MRSA. Therefore, it is important that clinicians are aware of the various and upcoming therapies that cover this bacterium. Read More

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October 2018
6 Reads

The Relative Risk of Achilles Tendon Injury in Patients Taking Quinolones.

Pharmacotherapy 2018 Sep 7;38(9):878-887. Epub 2018 Aug 7.

Department of Surgery, University of Texas Medical Branch, Galveston, Texas.

Objective: To examine the association between quinolone use and Achilles tendon injury, comparing well-matched cohorts of users of quinolone and nonquinolone antibiotics, and well-matched cohorts of quinolone users and patients not using any nonquinolone antibiotics.

Patients And Methods: This retrospective cohort study used Clinformatics data from 2008-2014. Using the propensity score, we matched quinolone users with other antibiotic users and quinolone users with nonusers. Read More

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September 2018
1 Read

Implications of Off-Target Serotoninergic Drug Activity: An Analysis of Serotonin Syndrome Reports Using a Systematic Bioinformatics Approach.

Pharmacotherapy 2018 Sep 29;38(9):888-898. Epub 2018 Jul 29.

Kasiska Division of Health Sciences, Department of Biomedical & Pharmaceutical Sciences, College of Pharmacy, Idaho State University, Meridian, Idaho.

Study Objective: Serotonergic adverse drug events (ADEs) are caused by enhanced intrasynaptic concentrations of 5-hydroxytryptamine (5-HT). No systematic process currently exists for evaluating cumulative 5-HT and off-target toxicity of serotonergic drugs. The primary study aim was to create a Serotonergic Expanded Bioactivity Matrix (SEBM) by using a molecular bioinformatics, polypharmacologic approach for assessment of the participation of individual 5-HT drugs in serotonin syndrome (SS) reports. Read More

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September 2018
1 Read

Relationship between International Normalized Ratio and Outcomes in Modern Trials with Warfarin Controls.

Pharmacotherapy 2018 Sep 16;38(9):899-906. Epub 2018 Jul 16.

U.S. Food and Drug Administration Center for Drug Evaluation and Research, Silver Spring, Maryland.

Introduction: A target international normalized ratio (INR) of 2-3 has been recommended for patients with atrial fibrillation (AF) and risk factors for thromboembolism. This recommendation is largely based on evidence from observational studies a decade ago. This study utilized collective data from modern trials with warfarin controls to examine the relationship of warfarin anticoagulation, as assessed by INR, on the clinical outcome events of interest. Read More

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September 2018
12 Reads
2.662 Impact Factor

Management of Pediatric Acute Hematogenous Osteomyelitis, Part I: Antimicrobial Stewardship Approach and Review of Therapies for Methicillin-Susceptible Staphylococcus aureus, Streptococcus pyogenes, and Kingella kingae.

Pharmacotherapy 2018 Sep 2;38(9):947-966. Epub 2018 Aug 2.

Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut.

Acute hematogenous osteomyelitis (AHO), often occurring in young children, is the most frequently diagnosed type of osteomyelitis in pediatric patients. Optimizing antibiotics is essential as delays to receipt of appropriate therapy can lead to chronic osteomyelitis, as well as impairments in bone growth and development. Antimicrobial stewardship programs (ASPs) are in a key position to help improve the care of patients with AHO as they contain a pharmacist with expertise in antibiotic drug selection, optimization of dosing, and microbiologic test review. Read More

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September 2018
8 Reads

Trends and Variation in Oral Anticoagulant Choice in Patients with Atrial Fibrillation, 2010-2017.

Pharmacotherapy 2018 Sep 26;38(9):907-920. Epub 2018 Jul 26.

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Objective: Since 2010, several non-vitamin K antagonist oral anticoagulants (NOACs) have been brought to the U.S. market, yet little is known regarding their evolving adoption for prophylaxis of atrial fibrillation (AF)-related stroke. Read More

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September 2018
3 Reads

A Fixed versus Weight-Based Dosing Strategy of Daptomycin May Improve Safety in Obese Adults.

Pharmacotherapy 2018 Sep 12;38(9):981-985. Epub 2018 Jul 12.

College of Pharmacy, University of Michigan, Ann Arbor, Michigan.

Objectives: To compare daptomycin exposures and predicted safety outcomes with a simulated weight-based and fixed dose in morbidly obese and nonobese subjects.

Methods: We performed a nonparametric population pharmacokinetic analysis of daptomycin concentration-time data from a prior obese and nonobese kidney function-matched cohort of healthy adult volunteers. Monte Carlo simulations were performed to compare the maximum concentrations (C ), minimum concentrations (C ), and area under the curve (AUC) with the standard daptomycin 6 mg/kg/day dose or a 500-mg daily fixed dose in obese and nonobese subjects. Read More

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September 2018
3 Reads