Journal of clinical pharmacy and therapeutics
-
Clinical Trial Controlled Clinical Trial
Appropriateness of a 4 mg/kg gentamicin or tobramycin loading dose in post-operative septic shock patients.
To determine the frequency with which early adequate peak serum concentrations (6-12 mg/ litre) can be achieved following a 4 mg/kg loading dose of gentamicin or tobramycin in post-operative septic shock patients. ⋯ One hundred per cent of the post-operative septic shock patients achieved target peak serum concentrations (mean 8.9+/-2.2 mg/litre) following a 4 mg/kg tobramycin or gentamicin loading dose. An expanded Vd (0.46+/-0.13 litres/kg) was also observed.
-
Comparative Study Clinical Trial
Aminoglycoside pharmacokinetics in African-Americans with normal renal function.
To compare aminoglycoside pharmacokinetics in African-Americans with normal renal function with published adult population values. ⋯ We conclude that aminoglycoside pharmacokinetics in African-Americans seem to be consistent with the published general population values. Thus, initiating aminoglycoside regimens using population dosing guidelines appears to be appropriate. However, due to the observed wide interpatient pharmacokinetic variability, individualized dosing is required with very close monitoring, to avoid or minimize toxicity.
-
The important prophylactic role of antithrombotic therapy against stroke in nonrheumatic atrial fibrillation (AF) has been clearly established in recent clinical trials. There have been suggestions, however, that practice has been slow to change in light of the findings of these trials. ⋯ While a number of published trials have demonstrated that antithrombotic agents confer substantial protection against stroke in patients with nonrheumatic AF, the drugs were underused in our setting. There is a need to improve antithrombotic use and to develop a better monitoring system for the provision of safer and more effective antithrombotic therapy.
-
To study the stability of morphine sulphate solutions under simulated administration conditions in a patient-controlled analgesic device. ⋯ This study demonstrated that the concentrating effect due to evaporation under the storage conditions described, over 16 days, was not of significance and the product was stable.
-
Review Comparative Study
Treatment with beta-blockers--the value of an even plasma concentration over 24 h.
The aim of this paper was to examine if there were clinical studies supporting a beneficial effect of an even plasma concentration over 24 h for the most frequently prescribed beta 1-blockers in clinical practice, metoprolol CR/ZOK and atenolol. There are several studies showing that metoprolol CR/ZOK has a more even plasma concentration compared with atenolol and conventional metoprolol tablets when administered once daily. There are also studies showing that metoprolol CR/ZOK produces a more even beta 1-blockade over 24 h. ⋯ The peak plasma concentration of atenolol coincides with increased general and leg fatigue, problems less evident when patients are on metoprolol CR/ZOK. The frequency and severity of other central nervous system related side-effects are comparable with metoprolol CR/ZOK and atenolol. In conclusion, there are several clinical studies supporting a beneficial effect of the even plasma concentration over 24 h achieved with metoprolol CR/ZOK.