Higher match rates were seen in the students completing the mock residency interview compared to ASHP national rates. In general, students completing the mock interview found the process helpful and felt better prepared for their residency interviews.

The benefits of long-term bisphosphonate therapy in patients at high risk of fracture likely outweigh the risks. In lower risk patients, such as those with a BMD in the osteopenic or normal range after two to five years of treatment and no history of fracture, consideration could be given to stopping therapy for two to five years.

Objective: To report a case of a severe interaction between simvastatin, amiodarone, and atazanavir resulting in rhabdomyolysis and acute renal failure.Background: A 72-year-old white man with underlying human immunodeficiency virus, atrial fibrillation, coronary artery disease, and hyperlipidemia presented with generalized pain, fatigue, and dark orange urine for 3 days. The patient was taking 80 mg simvastatin at bedtime (initiated 27 days earlier); amiodarone at a dose of 400 mg daily for 7 days, then 200 mg daily (initiated 19 days earlier); and 400 mg atazanavir daily (initiated at least 2 years previously). Laboratory evaluation revealed 66,680 U/L creatine kinase, 93 mg/dL blood urea nitrogen, 4.6 mg/dL creatinine, 1579 U/L aspartate aminotransferase, and 738 U/L alanine aminotransferase. Simvastatin, amiodarone, and the patient's human immunodeficiency virus medications were all temporarily discontinued and the patient was given forced alkaline diuresis and started on dialysis. Nine days later the patient's creatine kinase had dropped to 1695 U/L and creatinine was 3.3 mg/dL. The patient was discharged and continued outpatient dialysis for 1 month until his renal function recovered. The ability of statins to reduce the risk of cardiovascular morbidity and mortality in patients with dyslipidemia is well established. [1][2][3] In addition to their unmatched efficacy, the adverse effects associated with statins are usually mild and transient. 4 The most noteworthy adverse effects associated with statins are elevations in liver transaminases, myopathy, and rhabdomyolysis, which is characterized by massive muscle necrosis, myoglobinuria, and acute renal failure. 5,6 The risk of rhabdomyolysis with statin monotherapy is low and dose related. 4,[7][8][9][10] This risk increases in patients taking concomitant drugs that inhibit the cytochrome P450-related statin metabolism such as azole antifungals, cyclosporine, fibrates, macrolides, and non-dihydropyridine calcium channel blockers. 4,7,8 Patients with coronary artery disease are often on a number of medications and therefore the potential for drug interactions is an important consideration. This article describes a case of rhabdomyolysis in a patient taking concomitant simvastatin, amiodarone, and atazanavir. Case ReportA 72-year-old white man (weight, 72 kg; height, 175 cm; body mass index, 23.5 kg/m 2 ) presented to This article was externally peer reviewed.

A total of 827 patients at 3 clinics were included in the analysis. For diabetes, 77.1% had A1c <8%, 83.2% had LDL <130 mg/dL, and 76.3% had BP <140/80 mm Hg. For hypertension, 86.2% had BP <140/90 mm Hg. For hyperlipidemia, 80.6% had LDL <130 mg/dL. For asthma, 100% were on controller medication. One medication review was completed on 88.8% of patients. Generic prescribing rates ranged from 65.8% to 79.4%. IMPLICATIONS/ADAPTABILITY: A high percentage of patients achieved goal levels at clinics with clinical pharmacist services. A multidisciplinary approach to patient care may improve disease state management and medication cost savings.