Anemia and the Role of the Pharmacist

This home-study CPE has been developed to educate pharmacists and pharmacy technicians about the various types of anemia and their treatments

Detección precoz de cáncer de cérvix según los discursos de las matronas de atención primaria en Segovia, España

OBJETIVO: Analizar los discursos de las matronas de atención primaria sobre el acceso y la utilización del Programa Preventivo de Cáncer de Cérvix. PROCEDIMIENTOS METODOLÓGICOS: Se desarrolló un estudio cualitativo en un área de baja densidad poblacional, Segovia, España, que cuenta con un alto porcentaje de población rural, entre 2008 y 2009. Se utilizó como técnica la entrevista semi-estructurada. Se realizaron diez entrevistas a las matronas de atención primaria de las 16 Zonas Básicas de Salud. El análisis de la información se basó en las propuestas de la Teoría Fundamentada. ANÁLISIS DE RESULTADOS: El acceso y utilización del Programa Preventivo de Cáncer de Cérvix se relaciona con la utilización de la consulta de la matrona por las mujeres, sus vivencias de los exámenes de citología vaginal y su percepción de riesgo a padecer un cáncer de cuello uterino. La barrera percibida es la distancia para acceder a la consulta de la matrona, y para las mujeres inmigrantes, además son barreras la posibilidad de no disponer de tarjeta sanitaria y desconocer la existencia del Programa. La exclusión social es también considerada una barrera de acceso y utilización. Se identificó como el principal facilitador, la recomendación de los médicos de familia de participar en el Programa. CONCLUSIONES: Las matronas perciben desigualdades de acceso y utilización del Programa Preventivo de Cáncer de Cérvix que se relacionan tanto con características individuales de las mujeres, como con el medio geográfico donde viven y con la propia estructura del Programa. Hay situaciones de vulneración de la equidad en colectivos de mujeres poco representadas a nivel encuestal, como las mujeres inmigrantes y las que residen en zonas rurales

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

Depression in Cardiac Patients: Underrecognized and Undertreated

Depression occurs in 10% to 20% of post–myocardial infarction (MI) patients and 15% to 30% of heart failure (HF) patients. Depression has been associated with an increased risk of morbidity and mortality in these high-risk populations. Sertraline and citalopram are first-line antidepressants for post-MI patients; sertraline also has been proven safe for HF patients. It is unclear whether antidepressants improve cardiovascular (CV) outcomes. However, patients with improved depressive symptoms are more likely to be adherent to their cardiac medications and follow lifestyle modifications to reduce the likelihood of recurrent CV events. Pharmacists can play a pivotal role in screening cardiac patients for depression and educating them about their medications to improve clinical outcomes

Antiarrhythmic Therapy for Atrial Fibrillation

Antiarrhythmic therapy for atrial fibrillation comprises a broad range of medications that are used to prevent conversion from normal sinus rhythm to atrial fibrillation, as well as to control symptoms. These medications, although effective, require extensive monitoring and patient education. The antiarrhythmics most commonly used to maintain normal sinus rhythm in atrial fibrillation patients are the class IC agents flecainide and propafenone and the class III agents amiodarone, dronedarone, sotalol, and dofetilide. Recommended monitoring parameters include renal and hepatic function, drug interactions, QT prolongation, and exacerbation of heart failure. Patient education should include drug interactions, adverse effects, and recommendations for laboratory monitoring. Community pharmacists are in a unique position to provide guidance on these medications to patients and providers

Cardiovascular Conditions

Based on the chapter by Angela R. Mitchell and Tekoa L. King in the first edition of Pharmacology for Women\u27s Health.https://digitalcommons.chapman.edu/pharmacy_books/1003/thumbnail.jp

El Orzán : diario independiente: Año XII Número 3306 - 1929 enero 24

Patients with hyperlipidemia and chronic kidney disease (CKD) are at high risk for cardiovascular complications, including myocardial infarction, stroke, and arrhythmias. Patients with renal dysfunction should be closely monitored and treated with lipid-lowering therapy to reduce morbidity and mortality. While statins are the primary lipid-lowering therapy recommended in patients with CKD, other antihyperlipidemia medication classes include fibrates, bile acid sequestrants, niacin, ezetimibe, and omega-3 fatty acids. Pharmacists can play a key role in providing recommendations for therapy initiation, medication adjustments in renal dysfunction, and education about medications and adherence

Assessing Aspirin for Primary CVD Prevention

Aspirin has been used for various indications for many years. It also may play a role in primary and secondary prevention of cardiovascular disease. The vast majority of evidence supports the use of aspirin for secondary prevention. However, for primary prevention, the use of aspirin is debatable. Three studies published recently address the issue of aspirin use in primary prevention. Based on the results of these studies, the use of aspirin for primary prevention remains controversial, and its use in this role should be individualized

Considerations for Systemic Anticoagulation in ESRD

In the setting of end-stage kidney disease, the incidence and risk for thrombotic events are increased and use of anticoagulants is common. The incidence of bleeding, however, is also a frequent issue and creates additional challenges in the management of anticoagulation therapy. Patients with end-stage renal disease are typically excluded from large clinical trials exploring the use of anticoagulants, which limits our knowledge of optimal management approaches. Furthermore, varying degrees of renal failure in addition to conditions that alter the pharmacokinetics of various anticoagulants or pharmacodynamic response may warrant alternative approaches to dosing. This review will explore systemic chronic anticoagulation therapy in the setting of chronic kidney disease where hemodialysis is required. Agents discussed include vitamin K antagonists, low-molecular-weight heparins, fondaparinux, oral factor Xa antagonists, and direct thrombin inhibitors. Clinical challenges, approaches to dosing regimens, and tools for measuring responses and reversal will be explored