Journal of pharmacy practice
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Review Case Reports
ACE Inhibitor-Induced Angioedema of the Small Bowel: A Case Report and Review of the Literature.
Angiotensin-converting enzyme (ACE) inhibitors are known to cause angioedema. Most ACE inhibitor-induced angioedema cases describe swelling in the periorbital region, tongue, and pharynx. We describe a case of a 62-year-old female with presumed angioedema of the small bowel after more than a 2-year history of lisinopril use (with no recent changes in her dose of 40 mg orally twice daily). ⋯ The Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 7) between the development of angioedema of the small bowel and the lisinopril therapy. This case highlights the unique manner in which ACE inhibitor-induced angioedema may present. A review of published cases of ACE inhibitor-induced angioedema of the small bowel is provided.
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Fatalities from opioid overdose have risen by 117% over the past 10 years. Increasing access to the opioid antagonist, naloxone can combat this trend and saves lives. This study investigates the various routes of naloxone administration for opioid reversal in the prehospital setting. ⋯ There is little consensus on the optimal route of naloxone administration in the prehospital setting. Little training is required for proper administration of the intramuscular auto-injector; however, the high price of this device is a barrier to access. Intranasal naloxone appears to be the optimal dosage form when considering cost, effectiveness, and administrator safety. Pharmacists must be aware of trends in naloxone use, dosage forms, and administration when caring for patients and their communities.
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Observational Study
Intramuscular Ziprasidone Dosing for Acute Agitation in the Pediatric Emergency Department: An Observational Study.
Intramuscular (IM) ziprasidone is often used to manage acute agitation. Limited data exist on the pediatric dosing of ziprasidone in the emergency department (ED). ⋯ A significant dose difference exists between patients who required only one initial dose of ziprasidone compared to those who required additional medication. As a result, an initial dose of 0.2 mg/kg of IM ziprasidone may be considered when managing acutely agitated pediatric patients in the ED.