Physical examination has become a “lost art” for many clinicians across a variety of disciplines. Many pharmacists have not had formal physical examination training in school and those that have rarely utilize these skills after completing their training. Pharmacists are poised to employ physical examination in their patient care setting to evaluate the effects of therapy, triage patients, and guide clinical decision-making. This piece describes a general overview of the importance of physical examination and provides readers with a list of tools that pharmacists can use to reinforce prior knowledge of the cardiovascular physical examination.
Evidence from randomized controlled trials has demonstrated that the cornerstone pharmacologic therapies used in the management of chronic heart failure with reduced ejection fraction (HFrEF) do not confer the same benefits in patients with preserved ejection fraction (HFpEF). So why do we enroll both subgroups in trials of acute decompensated heart failure (ADHF)? In this entry, we’ll explore differences in pathophysiology between HFrEF and HFpEF and how they may result in variable responses to pharmacologic therapies commonly used in ADHF, particularly diuretics and vasodilators.
Anticoagulants are some of the most commonly implicated drugs in emergency department visits and hospitalizations due to adverse drug events. Medication errors can significantly influence these events, and pharmacists are at the forefront for preventing medication errors from reaching the patient. Part 1 of this 2 part series on anticoagulation safety will focus on common medication errors involving direct oral anticoagulants. Part 2 will focus on ways pharmacists can help prevent medication errors with anticoagulants, particularly as it relates to anticoagulation stewardship programs.