Journal of clinical pharmacy and therapeutics
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Heart transplantation studies have shown a relationship between the mycophenolic acid area under the curve (AUC) 0-12 h (MPA AUC(0-12h)) values and risk of acute rejection episodes and fewer side-effects in patient receiving cyclosporine during the first year post-transplant. However, measurement of full AUC is costly and time consuming and in this case it is an impractical approach to drug monitoring. Therefore, the authors describe a limited sampling strategy to estimate the MPA AUC(0-12h) value in adult heart transplant recipients. ⋯ The proposed three time-point equation to estimate AUC will be helpful in optimizing immunosuppressive therapy in heart transplantation.
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To review and document the current utilization of pharmacotherapy for the secondary prevention of acute coronary syndromes (ACS) in patients discharged from an Australian hospital. ⋯ There is a good adherence to evidence-based guidelines for the secondary prevention of ACS in this local setting. However, there is some potential underutilization in the older population and patients presenting with unstable angina. Variability in the use of oral anticoagulants alongside dual antiplatelet therapy indicates there is potentially a need for further guidance regarding the prescription of antithrombotics in those requiring poly-therapy.
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Randomized Controlled Trial
Post-operative pain relief following intrathecal injection of acetylcholine esterase inhibitor during lumbar disc surgery: a prospective double blind randomized study.
As spinal cholinergic receptors participate in the control of somatic pain, this effect could be potentiated by intrathecal injection of a cholinesterase inhibitor, neostigmine. ⋯ Injection of 100 microg hyperbaric neostigmine intrathecally was effective for pain relief, and reduced post-operative opiate demand.
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Pharmacists are in an optimal position to provide health care to patients with sleep disorders, however, at present their involvement in sleep services is limited. This study aimed to (i) establish an understanding of baseline levels of sleep health awareness, and attitudes towards sleep health in pharmacists and pharmacy undergraduate students in comparison with sleep physicians and (ii) collate the expressed preferences for sleep health training by final year pharmacy undergraduate students and practising community pharmacists. ⋯ These results provide a valid indication of the pharmacy profession's expressed and actual training needs, and should be used to inform the design, implementation and evaluation of a sleep health educational strategy, which targets practising community pharmacists and students.
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Constipation is one of the most frequent adverse drug reactions occurring in hospital inpatients. There is no evidence base for the use of laxatives in orthopaedic patients on opioids. The aim of the study was to determine the current nature of opioid and laxative prescribing, and the incidence of constipation in patients who require emergency neck-of-femur (NOF) surgery. ⋯ This study demonstrates that age and nutritional status are significant factors influencing the occurrence of constipation, though the prophylactic use of laxatives did not alleviate the incidence of constipation. There is a clinical need to develop a robust evidence base surrounding the best management of constipation in this vulnerable group of orthopaedic patients.