Live Longer with Lower Blood Pressure… even in People with Chronic Kidney Disease

Just hot off the press from the JAMA Internal Medicine ……. is the release of the results demonstrating all-cause mortality benefits by intensively lowering blood pressure in patients with chronic kidney disease (stage 3-5).  In this study, patients in the more intensive lowering group had 14% lower risk of all-cause morality than the less intensive group (odds ratio 0.86; 95% CI 0.76-0.97, p=0.01)

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Fosfomycin – the New Cipro?

Is fosfomycin the new ciprofloxacin?  Recently I have seen an increased number of prescriptions for fosfomycin in some of the long term care facilities. Fosfomycin is an antibiotic commonly indicated for urinary tract infection. The Infectious disease Society of America (IDSA) has recommended it as first line option for the treatment of urinary tract infection, along with trimethoprim-sulfamethoxazole and nitrofurantoin. This is in context to the increasing resistance of E Coli to fluroquinolones and as well as other antibiotics such as Amoxicillin-Clavulate in United States. We do have a different resistance pattern in Canada.

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Prophylaxis for Recurrent Urinary Tract Infection

Gloria is an 80 years old lady with a history of mild cognitive impairment, osteoporosis, hypertension, diabetes who often presents with an urinary tract infection (UTI) monthly. It is very unpleasant with the typical symptoms such as burning sensation, increased urinary frequency as well as slightly increased in irritability. Upon treatment with antibiotic, the symptoms go away quickly.  Who wants to have a urinary tract infection monthly?

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Assessing Kidney Function

Kidney function is important for many reasons. It is one of the main avenues to eliminate waste in our body, balance electrolytes as well as producing various hormones to regulate our bodily functions.  It is especially important to pharmacists because many medications are eliminated through our kidneys.  If there is any existing impairment, dosage adjustment or avoiding certain nephrotoxic medications are paramount.

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