Real Time Pharmacology

*Clinical atherosclerotic cardiovascular disease (ASCVD) includes acute coronary syndrome (ACS), those with history of myocardial infarction (MI), stable or unstable angina or coronary or other arterial revascularization, stroke, transient ischemic attack (TIA), or peripheral artery disease (PAD) including aortic aneurysm, all of atherosclerotic origin. Should I initiate statins or not? The 2014 National Lipid Association (NLA) recommendations provides a more comprehensive, patient-centered approach to identifying ASCVD risk.   In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) issued guidelines to use the intensity of statin therapy as the treatment goal instead of LDL-C or non–HDL-C targets, as in previous guidelines, to reduce atherosclerotic cardiovascular disease (ASCVD) risk (  Andrus & Lacaille, 2014  )  The guideline classifies statin therapy as  high-intensity (lowers LD...

Hispanic, 43 year old female Lots of stress in life Diabetes for 2 years Currently on Metformin 1000 mg BY MOUTH twice daily. Clinic ran comprehensive metabolic panel. Blood glucose 216, Hemoglobin A1C is 7.8 (ADA guideline: A1C of 6.5 or greater, confirmed diabetes with repeat) High triglycerides and cholesterol. Diabetes and numbers: American College of Physicians (ACP), in 2018 proposed changing the recommended A1C target guidelines.Based on outcomes and taking side effects and cost in to consideration they recommend patients with t ype 2 diabetes  should aim to achieve an HbA1C between 7 and 8  percent  instead of 6.5 to 7 percent, as previously advised by ADA.  The American Diabetes Association did not like the suggestions  stating the old standard are better, saying that a “reasonable A1C goal for many non pregnant adults with Type 2 diabetes is less than 7 percent. We went with ADA guidelines and added Glyburide 5 mg daily with lar...

This is a very nice article for healthcare students (Pharmacists, MD's, PA, NP and others Introduction The Subjective, Objective, Assessment and Plan (SOAP) note is an acronym representing a widely used method of documentation for healthcare providers. The SOAP note is a way for healthcare workers to document in a structured and organized way. This widely adopted structural SOAP note was theorized by Larry Weed almost 50 years ago. It reminds clinicians of specific tasks while providing a framework for evaluating information. It also provides a cognitive framework for clinical reasoning. The SOAP note helps guide healthcare workers use their clinical reasoning to assess, diagnose, and treat a patient based on the information provided by them. SOAP notes are an essential piece of information about the health status of the patient as well as a communication document between health professionals. The structure of documentation is a checklist that serves as a cognitive aid a...

Management of chemotherapy-induced diarrhea Often cancer patients on chemotherapy treatment experience diarrhea.  Diarrhea is frequent liquid-like loose stools. Imodium (Loperamide) can be used to manage diarrhea. Diarrhea, chronic - Irritable bowel syndrome initial; 4 mg ORALLY followed by 2 mg after each loose stool up to a maximum of 16 mg/day  maintenance; Average daily dosage 4 mg to 8 mg ORALLY up to a maximum of 16 mg/day, may be taken as a single dose or in divided doses  Diarrhea, acute 4 mg ORALLY followed by 2 mg after each loose stool up to a maximum of 16 mg/day Reference: Product Information: IMODIUM(R) oral capsules, Janssen Pharmaceutica Inc, Titusville, NJ, 2005. Contraindications pseudomembranous colitis, associated with the use of broad spectrum antibiotics; do not use as primary therapy bacterial enterocolitis, caused by invasive organisms including Salmonella, Shigella, and Campylobacter; do not use as pri...