Clinical therapeutics
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Clinical therapeutics · Dec 2010
ReviewAntiplatelet therapy after placement of a drug-eluting stent: a review of efficacy and safety studies.
Dual antiplatelet therapy with a thienopyridine (ticlopidine or clopidogrel) and aspirin is used to reduce the risk of late stent thrombosis and complications (myocardial infarction [MI] and death) after placement of a drug-eluting stent (DES). ⋯ The combination of clopidogrel (loading dose, 300-600 mg; maintenance dose, 75 mg/d) and low-dose aspirin (75-162 mg/d) for 12 months is the preferred regimen for the prevention of stent thrombosis and cardiac complications after DES placement. The combination of prasugrel and aspirin may be appropriate in patients with ACS, although it was associated with a significantly increased risk for bleeding. Triple antiplatelet therapy may be beneficial in certain high-risk patients.
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Clinical therapeutics · Dec 2010
Randomized Controlled TrialEfficacy of standard doses of Ibuprofen alone, alternating, and combined with acetaminophen for the treatment of febrile children.
Many pediatricians recommend, and many parents administer, alternating or combined doses of ibuprofen and acetaminophen for fever. Limited data support this practice with standard US doses. ⋯ During a single 6-hour observation period for these participating children, combined and alternating doses of ibuprofen and acetaminophen provided greater antipyresis than ibuprofen alone at 4 to 6 hours. ClinicalTrials.gov identifier: NCT00267293.
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Clinical therapeutics · Dec 2010
Comparative StudyModeling the cost-effectiveness of prothrombin complex concentrate compared with fresh frozen plasma in emergency warfarin reversal in the United kingdom.
Warfarin is the most commonly used oral anticoagulant in the United Kingdom. Indications for its long-term use include recurrent venous thrombosis, prosthetic heart valves, stroke prevention in atrial fibrillation, valvular heart disease, and prosthetic heart valve replacement. ⋯ PCC appeared to be a more cost-effective treatment than FFP for the emergency reversal of warfarin, from the perspective of the UK National Health Service, in this model analysis.
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Clinical therapeutics · Dec 2010
Randomized Controlled Trial Multicenter StudyEfficacy and tolerability of pregabalin using a flexible, optimized dose schedule in Korean patients with peripheral neuropathic pain: a 10-week, randomized, double-blind, placebo-controlled, multicenter study.
Clinical trials from various countries have reported the efficacy of pregabalin for reducing peripheral neuropathic pain. ⋯ Flexible-dose pregabalin (150-600 mg/d for 8 weeks) was associated with a significant, although modest, reduction in mean DPRS score; an improvement in anxiety and subjective sleep; and generally good tolerability compared with placebo in these Korean patients with neuropathic pain due to diabetic peripheral neuropathy, postherpetic neuralgia, or posttraumatic neuropathic pain.
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Clinical therapeutics · Dec 2010
Randomized Controlled Trial Multicenter StudyA randomized, double-blind, placebo-controlled, multicenter, repeat-dose study of two intravenous acetaminophen dosing regimens for the treatment of pain after abdominal laparoscopic surgery.
Intravenous acetaminophen has been approved in Europe and elsewhere for the treatment of acute pain and fever, and was recently approved by the US Food and Drug Administration (FDA) for the management of mild to moderate pain, the management of moderate to severe pain with adjunctive opioid analgesics, and the reduction of fever. ⋯ Both regimens of intravenous acetaminophen (1000 mg q6h and 650 mg q4h) were associated with statistically significant analgesic efficacy compared with placebo and were well tolerated in these adults after abdominal laparoscopic surgery. ClinicalTrials.gov identifier: NCT00564486.