Hospital Pharmacy - November 2017 - 700

700

Hospital Pharmacy 52(10)

Figure 2. Definitions for appropriate use of aldosterone antagonists.
Note. SCr = serum creatinine; GFR = glomerular filtration rate.
a
SCr in units mg/dL.
b
GFR in units mL/min.
c
Potassium in units mEq/L.

≤30 mL/min for 1 patient, who was 84 years old with a serum
creatinine of 1.5 mg/dL.

Table 1. Baseline Patient Data.

Statistical Methods

Age, y
Sex
Male
Female
Ethnicity
African American
Caucasian
Other
Serum potassium >5 mEq/La
eGFR (mL/min)
≥30
<30
Other therapies utilized
Loop diuretic
ACEI
ARB
Beta-blocker
Nitrate
Hydralazine
Digoxin
Pertinent medical history
Diabetes mellitus
Coronary artery disease

Patient characteristics were summarized using descriptive
statistics, including frequencies and proportions, means and
standard deviations, and medians and interquartile ranges.
Comparisons between 30- and 90-day readmission rates of
those receiving and not receiving an aldosterone antagonist
were made using Pearson's 2-sided chi-square test.

Results
Between August 16, 2011, and June 5, 2013, a total of 848
hospitalizations with a primary discharge diagnosis of HF
were screened and 346 patients met inclusion for the study.
Demographic data are shown in Table 1. Of note, 87.6% of
our patients were African American. Only 13 patients (3.8%)
had a discharge potassium level greater than 5 mEq/L. The
median serum creatinine was 1.4 mg/dL with an interquartile
range of 0.7 and 1.1 mg/dL and with an interquartile range of
0.7 in males (n = 202) and females (n = 144), respectively; 47
patients (13.7%) had estimated GFRs less than 30 mL/min.
Sixty-two percent of patients (n = 216) were discharged on
standard therapy of ACE inhibitor or ARB combined with a
beta-blocker (Table 1).
One hundred twenty-one patients (35%) received an aldosterone antagonist at discharge. Of these patients, 116
received an aldosterone antagonist consistent with the

N = 346

n (%)
62.6 (24-95)
202 (58.4)
146 (41.6)
303 (87.6)
40 (11.6)
3 (0.9)
13 (3.8)
298 (86.1)
48 (13.9)
295 (85.3)
227 (65.6)
30 (8.7)
287 (83.0)
83 (24)
72 (20.8)
171 (49.4)
163 (47.1)
178 (50)

Note. ACEI = angiotensin-converting enzyme inhibitor; ARB = angiotensin
receptor blocker; eGFR = estimated glomerular filtration rate.
a
All potassium values were checked but only abnormal values were
recorded.



Table of Contents for the Digital Edition of Hospital Pharmacy - November 2017

AKD—The Time Between AKI and CKD: What Is the Role of the Pharmacist?
Letter to the Editor
Antithrombotic Therapy Post Endovascular Stenting for Superior Vena Cava Syndrome
Pharmaceutical Pipeline Update
Janus Kinase Inhibitors for the Treatment of Rheumatoid Arthritis
Formulary Drug Reviews
Etelcalcetide
Treatment of Hypertriglyceridemia-Induced Acute Pancreatitis With Insulin, Heparin, and Gemfibrozil: A Case Series
Evaluation of Antimicrobial Stewardship–Related Alerts Using a Clinical Decision Support System
Compatibility, Stability, and Efficacy of Vancomycin Combined With Gentamicin or Ethanol in Sodium Citrate as a Catheter Lock Solution
Development of Institutional Guidelines for Management of Gram-Negative Bloodstream Infections: Incorporating Local Evidence
Underutilization of Aldosterone Antagonists in Heart Failure
Stability of Procainamide Injection in Clear Glass Vials and Polyvinyl Chloride Bags
Development of a Local Health-System Pharmacy Resident Society
Challenges and Solutions to New Manager Onboarding
Hospital Pharmacy - November 2017 - 649
Hospital Pharmacy - November 2017 - 650
Hospital Pharmacy - November 2017 - 651
Hospital Pharmacy - November 2017 - 652
Hospital Pharmacy - November 2017 - 653
Hospital Pharmacy - November 2017 - 654
Hospital Pharmacy - November 2017 - 655
Hospital Pharmacy - November 2017 - 656
Hospital Pharmacy - November 2017 - 657
Hospital Pharmacy - November 2017 - 658
Hospital Pharmacy - November 2017 - 659
Hospital Pharmacy - November 2017 - 660
Hospital Pharmacy - November 2017 - AKD—The Time Between AKI and CKD: What Is the Role of the Pharmacist?
Hospital Pharmacy - November 2017 - 662
Hospital Pharmacy - November 2017 - Letter to the Editor
Hospital Pharmacy - November 2017 - Pharmaceutical Pipeline Update
Hospital Pharmacy - November 2017 - Janus Kinase Inhibitors for the Treatment of Rheumatoid Arthritis
Hospital Pharmacy - November 2017 - Formulary Drug Reviews
Hospital Pharmacy - November 2017 - Etelcalcetide
Hospital Pharmacy - November 2017 - 668
Hospital Pharmacy - November 2017 - 669
Hospital Pharmacy - November 2017 - 670
Hospital Pharmacy - November 2017 - 671
Hospital Pharmacy - November 2017 - 672
Hospital Pharmacy - November 2017 - Treatment of Hypertriglyceridemia-Induced Acute Pancreatitis With Insulin, Heparin, and Gemfibrozil: A Case Series
Hospital Pharmacy - November 2017 - 674
Hospital Pharmacy - November 2017 - 675
Hospital Pharmacy - November 2017 - 676
Hospital Pharmacy - November 2017 - Evaluation of Antimicrobial Stewardship–Related Alerts Using a Clinical Decision Support System
Hospital Pharmacy - November 2017 - 678
Hospital Pharmacy - November 2017 - 679
Hospital Pharmacy - November 2017 - 680
Hospital Pharmacy - November 2017 - 681
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Hospital Pharmacy - November 2017 - Compatibility, Stability, and Efficacy of Vancomycin Combined With Gentamicin or Ethanol in Sodium Citrate as a Catheter Lock Solution
Hospital Pharmacy - November 2017 - 684
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Hospital Pharmacy - November 2017 - 687
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Hospital Pharmacy - November 2017 - Development of Institutional Guidelines for Management of Gram-Negative Bloodstream Infections: Incorporating Local Evidence
Hospital Pharmacy - November 2017 - 690
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Hospital Pharmacy - November 2017 - 692
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Hospital Pharmacy - November 2017 - Underutilization of Aldosterone Antagonists in Heart Failure
Hospital Pharmacy - November 2017 - 697
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Hospital Pharmacy - November 2017 - 700
Hospital Pharmacy - November 2017 - 701
Hospital Pharmacy - November 2017 - Stability of Procainamide Injection in Clear Glass Vials and Polyvinyl Chloride Bags
Hospital Pharmacy - November 2017 - 703
Hospital Pharmacy - November 2017 - 704
Hospital Pharmacy - November 2017 - 705
Hospital Pharmacy - November 2017 - 706
Hospital Pharmacy - November 2017 - Development of a Local Health-System Pharmacy Resident Society
Hospital Pharmacy - November 2017 - 708
Hospital Pharmacy - November 2017 - 709
Hospital Pharmacy - November 2017 - Challenges and Solutions to New Manager Onboarding
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