Journal of clinical pharmacy and therapeutics
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This study aimed to assess the effectiveness and safety of naloxone in the management of hepatic encephalopathy (HE). ⋯ Naloxone may improve HE. However, published data are limited.
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Although non-drug techniques are recommended to manage sleep disturbance, anxiety and challenging behaviours associated with dementia, several studies in Australia and overseas have noted a high use of psycholeptics (anxiolytics/hypnotics and antipsychotics) in aged care homes to treat these conditions. The aim of this study was to examine the current pattern of psycholeptic use in Tasmanian aged care homes and compare this data with other Australasian research. ⋯ In comparison with other recent Australasian studies, the current level of benzodiazepine use in Tasmanian aged care homes is of major concern, at approximately three times that reported in Sydney and New Zealand. There is also substantial use of multiple psycholeptic agents. Interventions to reduce benzodiazepine use and improve psycholeptic utilization in Tasmania need to be developed urgently. The results demonstrate the value of regular auditing of prescribing to highlight problem areas in prescribing.
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Review Comparative Study
The role of carbamazepine and oxcarbazepine in alcohol withdrawal syndrome.
The goal of this review is to evaluate the efficacy and safety of carbamazepine and oxcarbazepine in treatment of alcohol withdrawal syndrome (AWS) and determine the role in therapy of both agents. ⋯ Carbamazepine has demonstrated safety, tolerability and efficacy in treatment of moderate to severe symptoms of alcohol withdrawal in the inpatient setting. However, trials of carbamazepine provide inconclusive evidence for prevention of alcohol withdrawal seizures and DTs in comparison with benzodiazepines. Benzodiazepines remain the primary treatment of moderate to severe AWS.
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Clinical Trial Controlled Clinical Trial
Relationship of CYP2D6 genetic polymorphisms and the pharmacokinetics of tramadol in Chinese volunteers.
To investigate the relationship between CYP2D6 genetic polymorphisms and the pharmacokinetics of tramadol in Chinese volunteers. ⋯ CYP2D6*2 does not alter the pharmacokinetics of tramadol, whereas CYP2D6*10 did with homozygotes showing a more pronounced reduction than heterozygotes. The 32-h metabolic ratio of tramadol to M(1) were (mean +/- SD) 2.05 +/- 1.01, 2.13 +/- 0.83, 4.24 +/- 2.75 and 6.85 +/- 2.78, respectively, in CYP2D6*1/*1, CYP2D6*2/*2, CYP2D6*2/*10 and CYP2D6*10/*10 subjects, respectively.
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Judicious use of antibiotics is essential considering the growth of antimicrobial resistance and escalating costs in health care. This intervention study used treatment guidelines to improve antibiotic therapy by changing prescribing practice. ⋯ Antibiotic treatment guidelines for the infections most commonly occurring in hospitalized patients resulted in a significant increase in appropriate antibiotic use. The program was successful in changing prescription practice and achieved a sustained optimization of HAP therapy. Implementing, teaching and monitoring treatment guidelines can have a major impact on patient care.