Effect of Alirocumab Monotherapy vs Ezetimibe Plus Statin Therapy on LDL-C Lowering in Veterans With History of ASCVD.

Background: Guidelines recommend a low-density lipoprotein cholesterol (LDL-C) goal of < 70 mg/dL for patients with very high-risk atherosclerotic cardiovascular disease (ASCVD). While alirocumab monotherapy and ezetimibe plus statin therapy have both shown efficacy in independently reducing LDL-C, a direct comparison has not been conducted.

Methods: A retrospective chart review at the Veterans Affairs Sioux Falls Health Care System compared 20 patients with a history of ASCVD events who received alirocumab monotherapy to 60 patients receiving ezetimibe plus statin therapy.

The Safety and Efficacy of AUC/MIC-Guided vs Trough-Guided Vancomycin Monitoring Among Veterans.

Background: Vancomycin is a commonly used antibiotic for the treatment of methicillin-resistant s (MRSA), which requires therapeutic drug monitoring (TDM). Guidelines recommend targeting an individualized area under the curve/minimum inhibitory concentration (AUC/MIC) ratio of 400 to 600 mg × h/L to maximize efficacy and minimize the risk of acute kidney injury (AKI). Before these guidelines, the accepted method of vancomycin TDM was using trough levels alone.

Pharmacokinetic, pharmacodynamic and clinical evaluation of saxagliptin in type 2 diabetes.

Introduction: Dipeptide peptidase-4 (DPP-4) inhibitors such as saxagliptin are established and efficacious oral therapies in the management of type 2 diabetes. These agents have the potential to confer significant benefits in glycemic control without the risk of weight gain and hypoglycemia, which may be associated with other medications used to treat type 2 diabetes.

Areas Covered: This review examines the pharmacokinetics, efficacy and tolerability of saxagliptin for the management of type 2 diabetes.

Development of a congestive heart failure protocol in a rehabilitation setting.

A number of patients in a rehabilitation setting were being transferred to acute-care facilities with a diagnosis of congestive heart failure (CHF). A transfer penalty was charged to the rehabilitation facility based on each patient's length of stay. A multidisciplinary team was assembled with physician support to address the problem.