Mindi S. Miller

Role of Phosphodiesterase Type 5 Inhibitors for Lower Urinary Tract Symptoms

OBJECTIVE: To determine the efficacy of phosphodiesterase inhibitors for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). DATA SOURCES: MEDLINE and PubMed were searched from January 1, 2000, to October 31, 2012, using the MeSH terms phosphodiesterase inhibitor, lower urinary tract symptoms, benign prostatic hyperplasia, sildenafil, vardenafil, and tadalafil. Additional articles were obtained from references identified in the original search. STUDY SELECTION AND DATA EXTRACTION: English-language randomized controlled trials and review articles were evaluated. DATA SYNTHESIS: Men with BPH commonly experience lower urinary tract symptoms (LUTS) such as urgency, frequency, nocturia, and dribbling. α-Adrenergic antagonists have been the mainstay of medical treatment of LUTS but are associated with adverse effects such as orthostatic hypotension, dizziness, and sexual dysfunction. The 5-α reductase inhibitors are associated with sexual dysfunction, and treatment effects may be delayed for 6–12 months. Phosphodiesterase type 5 (PDE-5) inhibitors are effective for the treatment of erectile dysfunction (ED), and large-scale epidemiologic studies suggest a strong link between LUTS and ED. The available PDE-5 inhibitors (sildenafil, tadalafil, and vardenafil) have shown efficacy in the treatment of LUTS in several randomized controlled trials in men with and without concomitant ED. CONCLUSIONS: PDE-5 inhibitors consistently reduce LUTS associated with BPH. These medications may offer advantages over conventional therapies such as rapid onset of action, fewer adverse effects, and enhanced sexual function. Quality of life improvements have also been realized in men with BPH who receive PDE-5 inhibitors.

Impact of Advanced Pharmacy Practice Experience Placement Changes in Colleges and Schools of Pharmacy

Objective. To document the annual number of advanced pharmacy practice experience (APPE) placement changes for students across 5 colleges and schools of pharmacy, identify and compare initiating reasons, and estimate the associated administrative workload. Methods. Data collection occurred from finalization of the 2008-2009 APPE assignments throughout the last date of the APPE schedule. Internet-based customized tracking forms were used to categorize the initiating reason for the placement change and the administrative time required per change (0 to 120 minutes). Results. APPE placement changes per institution varied from 14% to 53% of total assignments. Reasons for changes were: administrator initiated (20%), student initiated (23%), and site/preceptor initiated (57%) Total administrative time required per change varied across institutions from 3,130 to 22,750 minutes, while the average time per reassignment was 42.5 minutes. Conclusion. APPE placements are subject to high instability. Significant differences exist between public and private colleges and schools of pharmacy as to the number and type of APPE reassignments made and associated workload estimates.

Web-based Portfolios for Pharmaceutical Care Plans During Advanced Pharmacy Practice Experiences

Objective. To implement and assess a Web-based patient care portfolio system for development of pharmaceutical care plans by students completing advanced pharmacy practice experiences (APPEs) throughout a statewide preceptor network. Design. Using a Web database, students in APPEs documented 6 patient cases within 5 disease state categories. Through discussion of the disease states and inclusion of patient information such as problems, desired outcomes, and interventions, a complete pharmaceutical care plan was developed for each patient. Assessment. Student interventions were compared by geographical regions to assess continuity of patient care activities by students. Additionally, students completed an evaluation of the portfolio course to provide feedback on the portfolio process. Students documented an average of 1.8 therapeutic interventions per patient case and documented interventions in all geographical regions. The majority of students indicated that the portfolio process improved their ability to develop a pharmaceutical care plan. Conclusion. The Web-based patient care portfolio process assisted with documentation of compliance with Accreditation Council of Pharmacy Education (ACPE) standards and College of Pharmacy Competency Statements. Students indicated the portfolio process was beneficial in developing skills needed for creating pharmaceutical care plans.

Phosphodiesterase inhibition in the treatment of autoimmune and inflammatory diseases: current status and potential

License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Journal of Receptor, Ligand and Channel Research 2015:8 19–30 Journal of Receptor, Ligand and Channel Research Dovepress