Pharmacotherapy
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To review the literature concerning drug-related problems that result in emergency department visits, estimate the frequency of these problems and the rates of hospital admissions, and identify patient risk factors and drugs that are associated with the greatest risk. ⋯ Drug-related problems are a significant cause of emergency department visits and subsequent resource use. Primary caregivers, such as family physicians and pharmacists, should collaborate more closely to provide and reinforce care plans and monitor patients to prevent drug-related visits to the emergency department and subsequent morbidity and mortality.
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Prescriptions for controlled-release oxycodone, a narcotic analgesic, recently contributed to a dramatic increase in pharmacy costs for a large private insurance company. To determine whether this agent offered clinical benefits over other available drugs that would justify its significantly greater cost, a systematic review of 16 clinical trials was undertaken. ⋯ For patients requiring a controlled-release opioid treatment, controlled-release morphine and methadone should be considered because they appear to be as effective as oxycodone and cost considerably less. Controlled-release oxycodone may be appropriate for some patients, particularly if they cannot tolerate other controlled-release or long-acting opioid analgesics.
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To identify independent risk markers for thrombocytopenia in critically ill patients. ⋯ Development of thrombocytopenia in critically ill patients is associated with specific diagnoses, packed red cell and fresh frozen plasma transfusions, pulmonary artery catheter insertion, and admission platelet count.