Avanafil is a potent PDE5 inhibitor and is an effective treatment option for ED.

Pharmacists need to apply outcomes from studies to reduce risk and improve patient care. Interpretation of outcomes is based on a variety of assessment tools, such as P values and confidence intervals (CIs). P values determine statistical significance of data, while CIs suggest the degree of clinical application. Many health care providers might not have the skill set required to carefully examine and interpret statistical results and then are required to assume that the researchers of the study correctly interpreted and presented the statistical results. The reluctance to examine statistical data often reflects a misconception that concepts such as P values and CIs are difficult to understand, while in reality, both can be interpreted once basic definitions and applications are understood. Measures of association such as number needed to treat can serve as effective tools for quantifying important parameters that ultimately affect patient care. A basic understanding of how to interpret and apply P values and CIs enhances one's ability to effectively assess the validity of results from the literature. An informed reader, armed with tools for critical analysis, is in the best position to evaluate studies and thereby discern which information is applicable to a specific patient care decision.

To review the use of the novel oral anticoagulant (NOAC) agents for the treatment of heparin-induced thrombocytopenia (HIT) from relevant clinical trial data. A MEDLINE, International Pharmaceutical Abstracts, ClinicalTrials.gov, and Google-Scholar searches (1966-March 2016) were conducted using the keywords: thrombocytopenia, NOACs, dabigatran, apixaban, rivaroxaban, edoxaban, Xa inhibitor, direct thrombin inhibitor. Articles evaluating the new oral anticoagulants for thrombocytopenia published in English and using human subjects were selected. Eight clinical trials were identified. References cited in identified articles were used for additional citations. Approximately 12 million hospitalized patients each year are exposed to heparin for thromboprophylaxis. HIT, an immune-mediated, prothrombotic adverse reaction is a potential complication of heparin therapy. As a result, heparin products must be immediately withdrawn and replaced by alternative anticoagulants to compensate for the thrombotic risk associated with HIT. Limitations exist with the only currently FDA approved heparin alternative, argatroban. NOACs have been considered as potential alternatives to traditional agents based on their pharmacologic activity. Case reports have indicated positive results in patients, with clinical outcomes and tolerability supporting the use of the NOACs as alternative agents in the treatment of HIT. Positive results have been reported for the use of NOACs in the treatment of HIT. Further robust studies are needed for definitive decision making by clinicians.

Treatment with CAN improves A1C levels, reduces SBP and body weight, and is overall well tolerated in older subjects with T2DM. Risks and benefits of treatment with CAN should be assessed in geriatric patients on a case-by-case basis. Safety in elderly patients was consistent with that of other phase 3 trials in the general population. Additional longterm cardiovascular studies are needed.

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