Thomas L. Lenz

Creighton University

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Michael S. Monaghan

University of Calgary

Daniel E. Hilleman

Creighton University

Nicole D. Gillespie

Creighton University

Michele A. Faulkner

Creighton University

Jessica J. Skradski

Creighton University

Maryann Z. Skrabal

Creighton University

Kathleen A. Packard

Creighton University

Rhonda M. Jones

Cincinnati Children's Hospital Medical Center

Richard L. Wurdeman

CHI Health Creighton University Medical Center - Bergan Mercy

Amy Wilson

AstraZeneca (United Kingdom)

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Creighton University

CHI Health Creighton University Medical Center - Bergan Mercy

University of Nebraska Medical Center

University of Nebraska at Omaha

CHI Health

VA Nebraska Western Iowa Health Care System

Chevron (United States)

University of Southern California

Southern California University for Professional Studies

Weatherford College

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Drugs That Negatively Affect Sleep

American Journal of Lifestyle Medicine (2014)

Thomas L. Lenz

Getting adequate sleep is a healthy lifestyle activity that is important for the body to function optimally both physically and mentally. Unfortunately, 70 million Americans suffer from chronic sleep loss or sleep disorders. Secondary causes of sleep disorders are often overlooked and can occur from the consumption of social or medicinal drugs. Common social drugs that can disrupt sleep include alcohol, caffeine, and nicotine. Certain medications can also have side-effects that can induce sleep disruptions. This article briefly reviews common social drugs and prescription medications that can negatively impact sleep.

Sleep

Affect

10.1177/1559827614544436

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Citations (8)

Impact of Nesiritide on Health Care Resource Utilization and Complications in Patients with Decompensated Heart Failure

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy (2004)

Thomas L. Lenz Pamela A. Foral Mark A. Malesker Claire Hunter Daniel E. Hilleman

To determine the impact of nesiritide on health care resource utilization and complications in patients hospitalized with decompensated heart failure.Retrospective case-control study.United States hospitals.Two hundred sixteen patients hospitalized for decompensated heart failure.One hundred eight patients who received a nesiritide infusion for a minimum of 12 hours during the first 48 hours after hospital admission were matched with 108 patients not receiving nesiritide. Health care resource utilization, consisting of hospital length of stay (LOS), rate of rehospitalization within 90 days, concomitant drugs administered, and laboratory and diagnostic tests, was determined for each hospital admission. Rates of adverse events also were recorded. Patients receiving nesiritide had a significantly shorter LOS in a critical care unit (p=0.03). General medical ward or step-down unit LOS was not different between the treatment groups. A favorable trend toward a lower rate of rehospitalization over the 90-day follow-up period was observed with nesiritide (p=0.07). The number of patients who developed life-threatening ventricular arrhythmias and hypotension was similar for both treatment groups. However, in patients receiving nesiritide, significantly less atrial fibrillation (p=0.03) and renal dysfunction (p=0.04) occurred compared with patients not receiving nesiritide.Nesiritide therapy is associated with significant reductions in both health care resource utilization and complications in patients with decompensated heart failure.

Nesiritide

10.1592/phco.24.13.1137.38081

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Citations (16)

Health Promotion and Wellness Topics in Pharmacy Education

Thomas L. Lenz Michael S. Monaghan Elizabeth A Hetterman

Promotion (chess)

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Dofetilide, a New Class III Antiarrhythmic Agent

Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy (2000)

Thomas L. Lenz Daniel E. Hilleman

Dofetilide is a new antiarrhythmic agent recently approved for conversion and maintenance of sinus rhythm in patients with atrial fibrillation (AF) and atrial flutter (AFl). It is a class III antiarrhythmic that works by selectively blocking the rapid component of the delayed rectifier outward potassium current. Dofetilide prolongs the effective refractory period in accessory pathways, both anterograde and retrograde. This can be seen on the electrocardiogram through a dose‐dependent prolongation of the QT and QTc intervals, with parallel increases in ventricular refractoriness. Approximately 80% of drug is excreted in urine, so dosing must be based on creatinine clearance. The elimination half‐life is approximately 10 hours. In clinical trials dofetilide was superior to flecainide in converting patients with AFl to normal sinus rhythm (NSR; 70% vs 9%, p<0.01). It also was more effective than sotalol in converting patients with both AF and AFl to NSR (29% vs 6%, p<0.05) and maintaining them in NSR for up to 1 year. Most patients converted within 24–36 hours. Dofetilide has a favorable risk:benefit profile. Torsades de pointes is the most serious side effect; it occurs in 0.3–10.5% of patients and is dose related. To minimize the risk of induced arrhythmia, patients who start or restart the drug should be hospitalized a minimum of 3 days for creatinine clearance measurements, continuous electrocardiographic monitoring, and cardiac resuscitation, if necessary.

Dofetilide

Antiarrhythmic agent

10.1592/phco.20.9.776.35208

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Citations (50)

DOAJ (DOAJ: Directory of Open Access Journals) (2012)

Yongyue Qi Jessica J. Skradski Michele A. Faulkner Maryann Z. Skrabal Nicole D. Gillespie

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Amiodarone vs Sotalol as Prophylaxis Against Atrial Fibrillation/Flutter After Heart Surgery

CHEST Journal (2002)

Richard L. Wurdeman Aryan N. Mooss Syed M. Mohiuddin Thomas L. Lenz

Sotalol

Antiarrhythmic agent

Supraventricular arrhythmia

10.1378/chest.121.4.1203

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Citations (72)

Therapeutic lifestyle strategies taught in U.S. Pharmacy Schools.

PubMed (2007)

Thomas L. Lenz Michael S. Monaghan Elizabeth A Hetterman

Several organizations representing pharmacy and other health professions stress the importance of teaching public health topics as part of training future practitioners. The objective of our study was to assess the number of U.S. pharmacy schools that incorporate lifestyle modification topics into their curricula.We developed an electronic survey on lifestyle modification topics and sent it to each of the 89 pharmacy schools in the United States. The survey defined lifestyle modification topics as topics that address nutrition, exercise, weight loss, smoking cessation, and alcohol use.Of 89 pharmacy schools contacted, 50 (56%) responded to the survey. Of the 50, four offer at least one required course in a lifestyle modification topic, seven offer at least one elective course, and one offers a required course that incorporates more than one lifestyle modification topic. Five required and nine elective courses were identified from the responses. Nutrition was the most commonly offered required course topic, followed by smoking cessation, exercise, weight loss, and alcohol use.Few pharmacy schools are addressing recommendations to promote public health education through formalized didactic courses. More courses on lifestyle modification topics should be offered to pharmacy students, who will be highly accessible to the public as pharmacists and will be able to offer education to enhance public health focused on the prevention of chronic diseases.

Lifestyle modification

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Using employee experts to offer an interprofessional diabetes risk reduction program to fellow employees

Journal of Interprofessional Care (2012)

Thomas L. Lenz Nicole D. Gillespie Maryann Z. Skrabal Michele A. Faulkner Jessica J. Skradski

A recent increase in the incidence of diabetes and pre-diabetes is causing many employers to spend more of their healthcare benefit budgets to manage the conditions. A self-insured university in the USA has implemented an interprofessional diabetes mellitus risk reduction program using its own employee faculty and staff experts to help fellow employees manage their diabetes and pre-diabetes. The interprofessional team consists of five pharmacists, a dietitian, an exercise physiologist, a health educator and a licensed mental health practitioner. In addition, the participant's physician serves as a consultant to the program, as does a human resources healthcare benefits specialist and a wellness coordinator. The volunteer program takes place at the worksite during regular business hours and is free of charge to the employees. The faculty and staff delivering the program justify the cost of their time through an interprofessional educational model that the program will soon provide to university students.

10.3109/13561820.2012.721816

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Citations (4)

Impact of nesiritide on complications and health-care resources in decompensated heart failure

Journal of Cardiac Failure (2003)

Thomas L. Lenz Pamela A. Foral Mark A. Malesker Chuma E. Wadibia Daniel B. Lucas

Nesiritide

10.1016/s1071-9164(03)00554-2

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Citations (2)

Medication Use for Hypercholesterolemia in the Pediatric Population

American Journal of Lifestyle Medicine (2012)

Thomas L. Lenz Jessica Larson

The past few decades have shown an increase in the prevalence of chronic conditions in the pediatric population. One of the chronic conditions that appears to be on the rise in this population is hypercholesterolemia. At the same time, the rate of obesity is increasing in children and adolescents and may be putting our youth at risk for abnormal lipid levels. First-line prevention and treatment should involve intensive lifestyle medicine therapy. If warranted, however, the use of medications may be started as early as 8 years of age, but this has many unknown variables related to safety and efficacy. Caution and vigilant observation for drug interactions and adverse events is warranted by the health care team and family members throughout treatment with drug therapy.

10.1177/1559827612455625

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