Clinical therapeutics
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Clinical therapeutics · Aug 2001
Randomized Controlled Trial Clinical TrialA randomized, double-blind comparison of ampicillin/sulbactam and ceftriaxone in the prevention of surgical-site infections after neurosurgery.
The use of prophylactic antibiotics has been shown to decrease the rate of surgical-site infections after clean neurosurgical operations, although previous clinical trials have provided no evidence that one antibiotic is superior to another for this purpose. ⋯ The results suggest that ampicillin/sulbactam and ceftriaxone are of similar prophylactic efficacy in clean neurosurgical operations. Because the acquisition cost of 2 g ceftriaxone is approximately 3 times greater than that of 3 g ampicillin/sulbactam, the latter may be more cost-effective than the former for neurosurgical prophylaxis; however, other relevant hospital-related costs were not assessed in this study.
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Clinical therapeutics · Jul 2001
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind, randomized comparison of intramuscularly and intravenously administered parecoxib sodium versus ketorolac and placebo in a post-oral surgery pain model.
Parecoxib sodium is an injectable cyclooxygenase-2-specific inhibitor developed for the treatment of acute pain. The analgesic efficacy of IV and IM parecoxib has been demonstrated in previous pilot studies using the post-oral surgery pain model. ⋯ Parecoxib IV and IM provided effective analgesia. The 40-mg dose was comparable to ketorolac 60 mg on most measures of analgesia but had a longer duration of action.
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Clinical therapeutics · Jun 2001
Meta AnalysisMeta-analysis comparing newer antipsychotic drugs for the treatment of schizophrenia: evaluating the indirect approach.
Meta-analysis is a useful method to assess the efficacy of newer antipsychotic drugs compared with older drugs or placebo. However, few trials directly compare novel drugs to each other. ⋯ An indirect meta-analysis of studies comparing olanzapine with haloperidol and risperidone with haloperidol yielded conclusions similar to those found in a direct comparative RCT of olanzapine and risperidone.
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Clinical therapeutics · Jun 2001
ReviewEntacapone: a catechol-O-methyltransferase inhibitor for the adjunctive treatment of Parkinson's disease.
When levodopa therapy is used in Parkinson's disease, degradation of the drug in the peripheral nervous system is associated with dyskinesias and motor fluctuations. Much of this degradation is produced by catechol-O-methyltransferase (COMT), an enzyme involved in the metabolism of catecholamines and catechol compounds. Inhibition of COMT activity prolongs the action of levodopa and reduces fluctuations in response. Entacapone is a selective inhibitor of COMT whose activity is primarily in the peripheral nervous system, with little effect in the central nervous system. ⋯ In clinical trials, adjuvant treatment with entacapone appeared to be an effective and well-tolerated therapeutic strategy in patients with Parkinson's disease who experience fluctuations in the response to levodopa therapy. The increased elimination half-life of levodopa with concomitant entacapone results in greater and more sustained plasma levodopa levels, with more constant dopaminergic stimulation in the brain and greater amelioration of parkinsonian symptoms.
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Clinical therapeutics · Jun 2001
Comparative StudyEfficacy of single-dose intravenous dolasetron versus ondansetron in the prevention of postoperative nausea and vomiting.
Postoperative nausea and vomiting (PONV) is a significant problem in surgical patients. The 5-hydroxytryptamine3-receptor antagonists ondansetron, dolasetron, and granisetron are being used to prevent PONV and avoid the adverse events associated with traditional antiemetics such as antihistaminic agents, anticholinergic agents, and dopamine antagonists. ⋯ There were no significant differences in efficacy between single doses of i.v. dolasetron 12.5 mg and i.v. ondansetron 4 mg in the prevention of PONV.