Pharmacotherapy
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Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind study comparing two single-dose regimens of ketorolac with diclofenac in pain due to cancer.
To compare the analgesic efficacy and safety of two single doses of ketorolac with diclofenac in acute cancer pain. ⋯ Intramuscular ketorolac 10 mg is adequate to relieve cancer pain, and is equivalent to ketorolac 30 mg and to diclofenac 75 mg.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of food on bromfenac, naproxen sodium, and acetaminophen in postoperative pain after orthopedic surgery.
To evaluate the effect of a standard meal on bioavailability of bromfenac, and on the relative analgesic efficacy and adverse effect liability of bromfenac 25 mg, naproxen sodium 550 mg, and acetaminophen 325 mg in the treatment of pain after orthopedic surgery. ⋯ Results of analgesic studies not taking patients' food status into consideration might be misleading. Although bromfenac 25 mg and naproxen sodium 550 mg produced significant analgesia compared with acetaminophen 325 mg, bromfenac's efficacy was significantly reduced when patients ate a standard meal. Adverse effects were transient and consistent with the pharmacologic profiles of the drugs.
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Sepsis is the thirteenth leading cause of death in the United States. Despite increased knowledge about its pathophysiology, availability of powerful antibiotics, and advanced diagnostic and monitoring techniques, mortality rates have not changed significantly over the past 30 years. Immunotherapy may improve outcome in the critically ill with sepsis, although trial results have been disappointing to date.
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Propofol is a sedative hypnotic agent often administered for intensive care sedation. A 28-year-old man who suffered a severe head injury developed elevated pancreatic enzymes after receiving extended high-dosage propofol therapy. ⋯ A definitive cause-and-effect relationship is unclear since head trauma also was reported to cause elevated pancreatic enzymes. Intensive care practitioners should be aware of this potential reaction.
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Case Reports
Acute renal failure, anterior myocardial infarction, and atrial fibrillation complicating epinephrine abuse.
After injecting the solution extracted from a Primatene Mist inhaler, a patient experienced epinephrine overdose that resulted in an acute myocardial infarction and acute renal failure. The exact amount of epinephrine injected was unknown, but was thought to be between 82.5 and 124 mg, more than 25 times higher than the amount normally administered. Health care providers should be aware of this readily available source of epinephrine and the potential adverse effects associated with its inappropriate use.