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2007211054153232113023July e180 PHARMACOTHERAPY Volume 34, Number 10, 2014 betic medications were also recorded. Incidence of hypoglycemic 2014 ACCP Annual Meeting episodes was compared using the chi square test. Austin, TX RESULTS: Seventy seven patients were included in the analysis. Fifty two percent of patients (n=40) were ≥ 65 years old, and (Pharmacotherapy 2014;34(10):e180–e298) doi: 10.1002/phar.1497 55% (n=43) had CrCl > 60 mL/minutes. Overall, there were 36 hypoglycemic episodes that occured in 311 “glyburide patient days”. There were a total of 28 and 8 episodes in patients ORIGINAL RESEARCH ≥65 years and <65 years old, respectively (RR 4.907, CI 2.29– 10.52). There were 16 and 19 hypoglycemic episodes in patients Adult Medicine with CrCl > 60 mL/minutes and CrCl ≤ 60 mL/minutes, respec- tively (RR 2.24, CI 1.18–4.25). Thirty percent (n=10) of episodes 1. Tolvaptan for euvolemic and hypervolemic hyponatremia in the occured in patients receiveing both glyburide and long-acting acute care setting. Jacqueline L. Olin, M.S., Pharm.D., BCPS, insulin (n=20). CDE, CPP, FASHP1, Gwen Mitchell, Pharm.D., BCPS2, Henry 3 CONCLUSION: In an effort to prevent hypoglycemia during Cremisi, M.D. ; (1)Wingate University School of Pharmacy, hospitalization, discontinuation of glyburide and use of alterna- Wingate, NC; (2)Department of Pharmacy, Novant Health tive antidiabetic medications upon admission is prudent, espe- Matthews Medical Center, Matthews, NC; (3)Novant Health cially in patients ≥65 years old, with CrCl ≤ 60 mL/minutes, or Inpatient Care Specialists, Novant Health Matthews Medical concomitantly receiving long-acting insulin. These results further Center, Matthews, NC validate existing evidence that suggests sulfonylureas are associ- PURPOSE: Hyponatremia is the most common electrolyte disor- ated with increased risk for hypoglycemia in selected hospitalized der in the hospital, with prevalence averaging 20% of admissions. patient populations and support recommendations that oral an- It is associated with co-morbidities, including a fourfold increase tidiabetic medications should be discontinued upon hospital in falls. Management strategies are varied and etiology-depen- admission. dent. Tolvaptan, a vasopressin antagonist, is indicated for hypo- natremia. It inhibits distal water reabsorption seen in high vasopressin states and elevates serum sodium. Tolvaptan use in 3E. Impact of lorcaserin in obese and overweight patients with the community hospital setting outside of clinical trials has not prediabetes on weight loss (WL) and reducing progression to been well characterized. We retrospectively reviewed our clinical diabetes. Richard Nesto, M.D.1, Randi Fain, M.D.2, Yuhan Li, experience with tolvaptan to evaluate adherence to institutional Ph.D.2, William Shanahan, M.D.3, William Soliman, Ph.D.2; (1) recommendations and help define reasonable expectations for its Lahey Hospital and Medical Center; (2)Eisai Inc.; (3)Arena role in hyponatremia management. Pharmaceuticals METHODS: All hospitalized patients who received tolvaptan in 2013, as identified by hospital billing reports, were included in this Presented at the 74th Scientific Sessions of the American Diabetes – single center, IRB-approved analysis. Medical records were used Association, San Francisco, CA, June 13 17, 2014. to obtain patient demographic data, tolvaptan indication, efficacy, duration and patient status at the end of the hospitalization. RESULTS: Thirty seven patient encounters were reviewed. Mean 4E. Lorcaserin free plasma levels at recommended dose are Æ sufficient to activate 5-HT2C but not 2A or 2B receptors. Eric age was 71 16.4 years and 20 subjects (54%) were female. 1 2 3 Hyponatremia was a contributory cause of admission in 15 Ravussin, Ph.D. , Yuhan Li, Ph.D. , David Unett, Ph.D. , Michael Morgan, Ph.D.3, William Shanahan, M.D.3, William (40.5%) and offending medications were discontinued in 7 (19%). 2 Associated causes of hyponatremia were heart failure (8.2%), cir- Soliman, Ph.D. ; (1)Pennington Biomedical Research Center; (2) rhosis (13.5%), and syndrome of inappropriate antidiuretic hor- Eisai Inc.; (3)Arena Pharmaceuticals mone (78%). Prior treatments included fluid restriction in 19 Presented at 74th Scientific Sessions of the American Diabetes (51%) and furosemide in 5 (13.5%), with tolvaptan administra- Association; June 13–17, 2014; San Francisco, CA. tion on average 3.2 days after admission. Most patients (78.4%) required ≤2 tolvaptan doses. Discharge to palliative care or death occurred in 8 (21.6%). Post-discharge review revealed 3 (8%) 5. Rivaroxaban compared to warfarin for the prevention of venous ≥ maintained serum sodium concentration 130 mg/dL. thromboembolism after major orthopedic surgery in a community CONCLUSION: Tolvaptan was primarily initiated after other hospital. Nicole Cieri, Pharm.D., BCPS1, Kristen Kusmierski, interventions and with limited duration per current recommenda- Pharm.D., BCPS, CACP2, Cynthia Lackie, Pharm.D.2, Michael tion. This cohort had complicating underlying chronic diseases and Botros, Pharm.D. Candidate1, Candace Villenuve, Pharm.D. offending medications. The results of this analysis will be used to Candidate1; (1)D’Youville College School of Pharmacy, Buffalo, further refine institutional recommendations with pharmacist input NY; (2)Pharmacy, Millard Fillmore Suburban Hospital, for risk/benefit stratification based on reasonable expectations. Williamsville, NY PURPOSE: This study retrospectively compared bleeding and venous thromboembolic (VTE) events during the hospital course 2. Evaluation of hypoglycemia associated with continuation of following major orthopedic surgery in patients administered riva- glyburide during hospitalization. Georgia Keriazes, Pharm.D., roxaban or warfarin. BCPS, BCOP, Dhaval Jivanji, Student Researcher, Sarah A. METHODS: Data was collected via retrospective chart review for Treadway, Pharm.D., BCPS, Samantha Bailey, Pharm.D., BCPS; all orthopedic surgery patients that received either rivaroxaban or Lakeland Regional Medical Center, Lakeland, FL warfarin for VTE prophylaxis from October 1, 2011 to March 31, PURPOSE: Although hyperglycemia in the acute care setting is 2014. Patients were excluded if they were ≤ 18 years of age. Data ideally managed with subcutaneous insulin, oral antidiabetic med- collected and analyzed included patient demographics, indication ications may be continued upon hospital admission. The objective for use (elective orthopedic surgery vs non-elective surgical repair of this study was to determine the incidence of hypoglycemia in of fracture), type of analgesia given, bleeding events, and VTE diabetic patients receiving glyburide during hospitalization. events. Statistical analysis for dichotomous data was done using a METHODS: A sample of adult patients admitted to non-ICU two-tailed Fisher’s exact test. medical floors between January 1, 2013 and June 30, 2013 and RESULTS: A total of 2432 patients received VTE prophylaxis who received at least one dose of glyburide during the index hos- following orthopedic surgery with rivaroxaban (n=610) or pitalization were retrospectively evaluated. Episodes of hypoglyce- warfarin (n=1822). The incidence of overall bleeding was not mia (blood glucose ≤ 70 mg/dL) were recorded. For each patient, significantly different between patients who received rivarox- the number of “glyburide patient days” was calculated using the aban compared to warfarin (1% vs 0.3%; p=0.09). Wound date range for doses administered. Additional prescribed antidia- ACCP 2014 ANNUAL MEETING ABSTRACTS e181 complications (a composite of excessive wound hematoma and PURPOSE: To compare 30 day all-cause readmission rates in reported surgical-site bleeding resulting in a therapy change or patients with a discharge diagnosis of heart failure (HF) and evi- intervention) were higher in those who received rivaroxaban dence of fluid overload that had an increase in loop diuretic dose compared to warfarin (0.5% vs 0%; p=0.02). The incidence of at discharge versus those with no change or a decrease in loop VTE was not significantly different in those who received riva- diuretic dose at discharge in relation to their home diuretic dose roxaban compared to warfarin (0.7% vs 0.4%; p=0.51). Twenty- prior to admission. six patients (4.3%) received rivaroxaban following non-elective METHODS: Inclusion criteria were adults ≥18 years old admitted surgery, none of which experienced an adverse event during hos- between January 1st 2012 and December 31st 2012 with a dis- pitalization. Out of the 49 rivaroxaban patients who received epi- charge diagnosis of heart failure with reduced ejection fraction dural analgesia, none experienced an adverse event during (HFrEF), defined as left ventricular ejection fraction (LVEF) hospitalization. ≤40%, and evidence of fluid overload. Patients were included if CONCLUSION: The use of rivaroxaban at our institution was they were on a loop diuretic on admission and discharge. Patients not associated with an increased risk of overall bleeding events or were divided into two groups based on loop diuretic dose at dis- VTE compared to warfarin. Rivaroxaban was associated with a charge; those who were discharged on an increased diuretic dose small but significant increase in wound complications. Rivarox- and those on a dose less than or equal to the dose upon admis- aban use for VTE prophylaxis after non-elective surgical repair of sion. fracture was not associated with an increased risk of adverse RESULTS: In 2012, there were 438 patients with
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