The Annals of pharmacotherapy
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of three morphine regimens in postsurgical patients using patient-controlled analgesia.
To compare the efficacy and toxicity of three patient-controlled analgesia (PCA) morphine regimens. ⋯ No significant differences in the efficacy or toxicity of the three morphine PCA regimens were identified.
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Letter Case Reports
Isotretinoin: possible cause of acute seizure and confusion.
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To evaluate the use of intrathecal baclofen for the treatment of muscle spasticity in patients with spinal cord injury. ⋯ Muscle spasms and spasticity constitute a significant problem in spinal cord injuries, interfering with rehabilitation and leading to inconveniences and complications in these patients. Oral baclofen is the drug of choice for spasticity due to spinal cord trauma. It often is ineffective, however, because of the large dosages required to cross the blood-brain barrier and the subsequent appearance of central nervous system adverse effects. These adverse effects are not tolerated by many patients. Intrathecally administered baclofen has been approved by the Food and Drug Administration (FDA) for the treatment of spasticity in patients with spinal cord injury who are refractory to or cannot tolerate oral baclofen. It is intended for use only in implantable pumps approved by the FDA for the administration of baclofen into the intrathecal space. Intrathecal administration achieves high concentrations in the spinal cord with small dosages, thus reducing the incidence of central nervous system adverse effects. To date, approximately 350 patients with spinal cord injury have been treated with intrathecal baclofen. Reductions in spasticity have been demonstrated in both open-label and placebo-controlled trials. Patients also often make substantial gains in activities of daily living. Few adverse effects and complications have been reported. However, tolerance to the clinical effects of intrathecal baclofen has been reported. Further studies are needed to determine specific patient populations that may benefit most from intrathecal baclofen administration. Individual dosage ranges and follow-up care also need to be defined more completely. In addition, the question of whether tolerance detracts from long-term clinical benefits with intrathecal baclofen needs to be addressed.
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Comparative Study
Physical and chemical compatibility of intravenous ciprofloxacin with other drugs.
To determine the physical and chemical compatibilities of ciprofloxacin lactate infusion with other commonly used intravenously administered drugs. ⋯ Ciprofloxacin ready-to-infuse solution is compatible with most of the drugs studied except heparin, furosemide, teicoplanin, and, perhaps, metronidazole. Because only the stability and potency of ciprofloxacin were studied, further testing is needed to confirm if any chemical deterioration of the other drugs occurred when combined with ciprofloxacin.