MbShea@PWP@English@UMCP

Abstract: Diabetes was long known to be related to the circulatory system problems. Recent and ongoing clinical studies continue to show diabetes as a risk factor for heart failure. This six part review of pharmacotherapy literature is meant to introduce future pharmacist modern knowledge for pharmacist to deal with contraindications and interactions involving diabetes medicines and/or heart medication. This review begins with introductionto relationship between diabetes and heart failure. Then, two mechanisms for diabetes causing heart failure are examined. Third diabetes medicines are introduced; which allows discussion of part four: contribution of diabetes medicine to heart failure risk. Fifth medicines used for heart health and the biochemistry is introduced. Part six is best pharmacy practices for prevention of heartfailure in diabetes. Theses six parts will allow pharmacy student basic understanding needed to give drug expert consult to patient and prescriber.

Readers profile: the difficult audience is an inexperienced student pharmacist who tends to be quick to call prescriber for writing wrong prescription. This student is eager about helping patient. He does not reject science showing link between DM and CVD. He is also becoming more aware of pharmacology but does not understand that he is inexperienced. This student may not get the whole message, which is that patients should be given prescription for diabetes even if the prescription may eventually worsen heart health because of ethics regulations. I also know experienced pharmacist who finds many errors from physician and physician assistant and makes calls to teach them about the error. This pharmacist may reject the ethics of pharmacy. One more difficult-to-reach-reader is bored or lazy student who may become a pharmacist that quickly dispenses prescriptions without consultation with batient or prescriper.

Reader response: I want to trust the biochemistry showing that heart health worsens with diabetes. I accept the validity of some diabetes medicine excerbate heart health. These prescribers ignoring science of DM and CVD should have their prescriber license taken away. I promise to reject or harshly scrutinize glitasones for diabetes because that class of medicines is dangerous for heart. I will call prescriber to tell him reconsider changing sulfonylurea to metformin as first line for patients, especially renal impaired patient; and I will ask for creatinine clearance before approving to dispense sulfonylurea.

M -- you are on the right track. Please read your prose aloud to catch some of the typos here. You can also ask a friend to proofread this work. Use section headings to help the audience see your organization and chose which parts of the document will fit their needs.

Did you find the pharmacy journals to cite, regarding best practices for section six?