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Issue: February 2017 •  Archive  •  Subscribe •  Unsubscribe
In This Edition Featured Article Featured CE
•  Editor's Notebook
•  Counseling Pearls
•  Senior Care
•  Clinical Corner
•  Consult Your Pharmacist
•  Educational Spotlight
•  Quick Poll
     – Blood Pressure Targets
  Photo Direct Oral Anticoagulants for the Prevention of Stroke in Nonvalvular Atrial Fibrillation
Several newly approved DOACs may be used in patients who cannot undergo INR monitoring or maintain therapeutic INR.
  Photo Primary and Secondary Prevention of Heart Disease
Interventions by pharmacists lead to reductions in risk behaviors and factors for coronary heart disease.

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Editor's Notebook
Taking Patient Counseling to Heart

The counseling of cardiovascular patients by pharmacists has a potentially enormous health-outcomes payoff.
Counseling Pearls
Photo Management of Coronary Artery Disease and Chronic Stable Angina

Angina pectoris, characterized by discomfort typically located in the chest, neck, or left arm, is a clinical manifestation of CAD. Risk-factor reduction can be achieved through optimal treatment of diabetes, hypertension, and hyperlipidemia.
Photo Recognizing and Treating Venous Stasis Ulcers

Venous ulcers, which are perceived to be the most common cause of ulcerations affecting the lower extremities, can be severe and debilitating in nature. Primary risk factors include older age, previous leg injury, deep venous thrombosis, and phlebitis.
Senior Care
Myocardial Infarction in Women: Milder Symptoms, Aspirin, and Angioplasty

About one-third of women do not experience chest pain during a heart attack.
Clinical Corner
Photo Updated Treatment Options in the Management of Hyperkalemia

Until recently, FDA-approved therapies for the management of hyperkalemia had remained unchanged for more than 50 years. Patiromer was recently approved for chronic hyperkalemia, and other medications are in development.
Photo Triple Therapy for a Cardiac Indication in a Veteran Population

Concomitant use of aspirin, a thienopyridine, and an anticoagulant tends to result in higher bleeding rates, even in patients with appropriate indications. After this regimen was altered to preemptively reduce the bleeding risk, no episodes occurred in follow-up.
Consult Your Pharmacist
OTC Supplements for the Management of High Cholesterol

Nonprescription options that may be beneficial include immediate-release niacin, omega-3 fatty acids, and soluble fiber.
Educational Spotlight
Antiepileptic Drugs for Epilepsy

Available AEDs are associated with a number of adverse effects and drug-drug interactions.
Pharmacologic Management of HIV-Associated Wasting Syndrome

The key goals are to promote weight gain and prevent further reduction of lean body mass.
Care and Treatment of Dementia

As the population ages, the human and economic costs of Alzheimer's disease and other dementias are significant.
Discovery Could Enable Earlier CV Disease Detection
London, England—
Research from Guy's and St. Thomas' and King's College indicates that screening methods for cardiovascular (CV) diseases such as strokes and heart attacks could be improved by measuring different biological signposts than those currently being assessed. Currently, the chief focus is on apolipoprotein (apo) A1 and apoB, which are the main components of HDL and LDL, respectively. Using mass spectrometry, researchers found that apoE, apoC2, and apoC3, which are associated with very-low-density lipoproteins and are linked predominantly to triglycerides, had a stronger association with CV disease than apoA1 and apoB did. This discovery could allow doctors to better predict the development of CV disease at an earlier stage, as well as offer patients more personalized treatment.
Antiepileptics During Pregnancy Likely Not Harmful to Child's Health
Aarhus, Denmark
Previous studies have showed that antiepileptics taken during pregnancy could cause congenital fetal malformations and affected the child's brain development. However, a new study of 963,010 children born between 1997 and 2012 found that those whose mothers took antiepileptics during pregnancy (n = 4,478) did not visit the doctor more often than children who were not exposed to these agents in utero, and being born to a mother who took antiepileptics during pregnancy appeared not to harm the child's health. A lack of knowledge remains regarding the general health of children exposed to antiepileptics in utero, but this new study is reassuring for women who need to take these medications while pregnant.
Collaborative Care Improved Symptoms in Older Adults With Mild Depression
York, England—
According to University of York researchers, collaborative care versus usual care in older adults with subthreshold depression resulted in improvements in depressive symptoms after 4 months. Of 704 adults aged 65 years and older, 344 received collaborative care and 361 received usual primary care; participants completed an average of six weekly sessions of behavioral activation, and functional impairments were evaluated. During follow-up assessments, the proportion of collaborative-care patients meeting criteria for depression was lower than that of usual-care patients. However, the clinical importance of this finding is uncertain. "Although differences persisted through 12 months, findings are limited by attrition, and further research is needed to assess longer-term efficacy," the researchers noted.
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