Clinical therapeutics
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Clinical therapeutics · Mar 2012
The influence of sparse data sampling on population pharmacokinetics: a post hoc analysis of a pharmacokinetic study of morphine in healthy volunteers.
Intensive sampling of patients for drugs with complex pharmacokinetic profiles is difficult to perform in the clinic or hospitalized patient setting. We seek to address whether sparse sampling can obtain pharmacokinetic parameter values similar to those with traditional modeling from a post hoc analysis of 2 previous clinical trials. ⋯ This post hoc analysis suggests that intensive sampling for discerning complex, 3-compartment pharmacokinetic models, such as morphine, may not be necessary. Sparse sampling achieved accurate model structure recognition and parameter identification for predicting concentrations of very complex drug-dosage regimens.
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Clinical therapeutics · Mar 2012
Morphine use in hospitalized children in the United States: a descriptive analysis of data from pediatric hospitalizations in 2008.
Morphine is among the top 10 medications given to children in the inpatient setting. It is not labeled for any pediatric indication, making it one of the drugs most widely used off-label in pediatrics. ⋯ Based on the data from this analysis, morphine was used in hospitalized children in all age groups, despite the lack of pediatric labeling. Common conditions such as appendicitis and fracture were leading diagnoses associated with morphine use.
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Clinical therapeutics · Mar 2012
A retrospective database analysis of neuropathic pain and oral antidiabetic medication use and adherence among Texas adults with type 2 diabetes enrolled in Medicaid.
Adherence to oral antidiabetic (OAD) medications is essential in achieving glycemic control and slowing the progression of diabeties-related complications such as neuropathic pain. OAD medication adherence has been suboptimal and adding neuropathic pain medications may negatively affect adherence. However, little is known about adherence to neuropathic pain medications by patients with diabetes and how this may be related to OAD medication adherence. ⋯ Overall, these data suggest that mean adherence to both PDPN and OAD medications was suboptimal (MPR <80%). Patients who were adherent to PDPN medications were more adherent to OAD medications in the post-index period, but OAD medication adherence was independent of the type of PDPN medication used. OAD adherence decreased from pre- to post-index (ie, when patients were prescribed PDPN medications), which may indicate an opportunity for practitioners to emphasize the importance of OAD adherence in reducing the progression to neuropathy.