Pharmacology

Clostridium difficile infection: 
Managing the risks

May 11, 2012

Proton pump inhibitors can increase the risk of C difficile infection, and some types of probiotics have a role in treatment and prevention.
 

DVT prophylaxis with aspirin
in orthopedic surgery patients

April 04, 2012

The 2012 ACCP guidelines on thromboprophylaxis after orthopedic surgery contain some surprises, basing recommendations on the type of surgery and sometimes countermanding earlier versions.
 

Urinary tract infection: Consistent therapy to 
reduce resistance

, March 13, 2012

A recent update to the clinical practice guidelines for the treatment of UTI hopes to establish a long overdue consensus regarding optimal approaches to this common infection.
 

How do dihydropyridine and nondihydropyridine CCBs differ?

March 07, 2012

All calcium channel blockers have a similar mechanism of action, but they are not interchangeable and can exert very different physiologic effects.
 

Antimicrobial stewardship: 
A proactive approach to combating resistance

, February 09, 2012

Until new antimicrobials with novel mechanisms can be developed, we must use antibiotic stewardship to safeguard the efficacy of the medications we have.
 

Phenytoin: An old friend that 
still confuses us

February 07, 2012

Dosing of phenytoin is complicated by its unique properties: it is highly lipophilic, highly protein-bound, and undergoes capacity-limited pharmacokinetics at therapeutic levels.
 

Prescribing opioids safely in 
patients with an opiate allergy

January 09, 2012

IgE-mediated allergy to opioids is rare but life-threatening, so distinguishing between a true allergic reaction and side effects to a previously prescribed opioid is crucial.
 

Interactions between supplements and drugs: Deciphering the evidence

December 12, 2011

Make sure you know what dietary supplements your patient uses because the potential for interaction with a medication you prescribe is significant.
 

How should extravasation 
injuries be treated?

December 07, 2011

Most extravasation injuries do not result in significant harm, but prompt recognition and early treatment are crucial.
 

Understanding the appropriate and effective use of vancomycin

November 09, 2011

Vancomycin should be dosed aggressively early on, with a loading dose given that is sufficient for rapid achievement of target concentrations.
 

Oral anticoagulation: A review of the current and emerging therapies

, Elise K. Dzintars, MMS, PA-C; R. Brock Phillips, MMS, PA-C; Reamer L. Bushardt, PharmD, PA-C November 04, 2011

Now that options besides warfarin are available, clinicians must weigh the advantages and disadvantages, safety, tolerability, efficacy, price, and ease of use of each agent.
 

Starting levothyroxine therapy; treating pernicious anemia

October 26, 2011

This month's topics are how to initiate treatment in patients with hypothyroidism and cobalamin dosing in patients with pernicious anemia.
 

Simvastatin dosing restrictions; monitoring amiodarone therapy

September 20, 2011

This month's topics are preventing myopathies when using simvastatin and safe use of amiodarone.
 

Erythromycin for GI motility; 
sunscreens; enoxaparin in obesity

August 17, 2011

This month's topics are using erythromycin for GI motility, choosing a sunscreen, and DVT prophylaxis with enoxaparin in obese patients.
 

Tapentadol for pain; enoxaparin after prosthetic valve replacement

July 15, 2011

This month's topics are the new opioid analgesic tapentadol and using enoxaparin after prosthetic valve surgery.
 

Comparing brand name drugs 
to their generic equivalents

June 09, 2011

Are generic products truly equivalent to their brand name counterparts, particularly narrow therapeutic index (NTI) medications such as antiepileptics, immunosuppressants, anticoagulants, and levothyroxine?
 

When to take statins; Lovaza versus OTC fish oil supplements

May 06, 2011

This month's questions are whether statins are best taken at night and whether OTC fish oil supplements are as effective as Lovaza.
 

Differences between the varicella vaccines; using dabigatran

April 08, 2011

This month's topics are the differences between the varicella vaccines and more on the new anticoagulant dabigatran.
 

Does genetic screening reduce adverse 
effects when initiating warfarin therapy?

March 24, 2011

Although data show a correlation between using a pharmacogenetic algorithm and shorter times to a stable warfarin dose and more time spent in the therapeutic range, it is unclear whether these factors cause a significant decrease in adverse clinical events.
 

PA prescribing of buprenorphine; swapping out aminoglycosides

March 08, 2011

This month's topics are the rules for prescribing buprenorphine and the interchangeability of gentamicin and tobramycin.
 

Substitutions for propoxyphene; Macrobid versus Macrodantin

February 08, 2011

This month's topics are the difference between Macrobid and Macrodantin and what to use instead of Darvon in patients needing pain management.
 

The way we practice now

January 17, 2011

Prior to the modern codification of ADHD (attention-deficit/hyperactivity disorder), clinicians had coined the term MBD (minimal brain dysfunction) in reference to children who exhibited traits of impulsivity, hyperactivity, and inability to stay focused on task.
 

The difference between Tdap and DTaP; dabigatran versus warfarin

January 11, 2011

This month's topics are the difference between Tdap and DTaP vaccines, and the new anticoagulant dabigatran.
 

The antiplatelet effects of aspirin; 
nattokinase as a blood thinner

December 10, 2010

This month's topics are the antiplatelet effects of aspirin and uses for nattokinase as a blood thinner.
 

Tendinopathy resulting from the use of fluoroquinolones: Managing risks

December 01, 2010

Although well-tolerated by most patients, fluoroquinolones can produce this serious 
condition.
 

Metoclopramide for migraines; how to stock a first aid kit

November 12, 2010

This month's topics are using metoclopromide to treat migraine in the emergency department and stocking a first aid kit appropriately.
 

Irritable bowel syndrome: Relieving the symptoms, and the frustration

November 02, 2010

IBS is not life-threatening, but its symptoms are life long. Finding an effective treatment can be a frustrating process for PAs and patients.
 

The Beers criteria; antibiotic 
and metoprolol dosing

October 15, 2010

This month's topics are the Beers criteria, understanding antibiotic dosing, and switching a patient from immediate-release to extended-release metoprolol.
 

Travel-related infections: Diagnosis and treatment of exotic fevers

October 06, 2010

Patients rarely seek pretravel medical care, so PAs should be aware of common illnesses patients may present with after foreign travel.
 

PCOS: Clinical presentation guides treatment of this multifaceted disease

, Gloria Stewart, EdD, PA-C, ATC October 05, 2010

The clinical presentation of patients with PCOS can vary. Treatment is based on recognizing its many manifesting symptoms.
 

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