Pharmacotherapy
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A 39-year-old man developed significant methemoglobinemia after receiving benzocaine spray; he was treated appropriately with intravenous methylene blue. The patient's methemoglobin levels decreased, but this was followed by a critical rebound phenomenon to levels frequently considered near fatal. After further treatment with methylene blue, the patient's methemoglobin levels returned to normal. Clinicians need to be aware that a decreasing level of methemoglobin does not necessarily indicate that a crisis has passed and that further monitoring and treatment may be indicated.
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Randomized Controlled Trial Clinical Trial
Pharmacokinetics and dose-proportionality of oxymorphone extended release and its metabolites: results of a randomized crossover study.
To evaluate the pharmacokinetics and dose-proportionality of four dose strengths (5, 10, 20, and 40 mg) of oxymorphone extended release (ER) under both single-dose and steady-state conditions. ⋯ The pharmacokinetic profile of oxymorphone ER demonstrates linearity and dose-proportionality under single-dose and steady-state conditions for the parent compound and its metabolites for doses of 5-40 mg.
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We developed a model for the provision of clinical pharmacy services in United States hospitals in 2020. Data were obtained from four National Clinical Pharmacy Services database surveys (1989, 1992, 1995, and 1998) and from the American Health-System Association's 2000 Abridged Guide to the Health Care Field. Staffing data from 1998 indicated that 45,734 pharmacist and 43,836 pharmacy technician full-time equivalent (FTE) staff were employed in U. ⋯ The average U. S. hospital (based on an average daily census of 108.97 +/- 169.45 patients) would need to add a maximum of 3.32 pharmacist FTEs to provide these core clinical services (if they were not provided already by the hospital). Using this evidence-based approach, the five selected core clinical pharmacy services could be provided with only modest increases in clinical pharmacist staffing.