The Annals of pharmacotherapy
-
A number of studies evaluated the pharmacologic management of patients with coronary artery stents. Four studies demonstrated a low subacute thrombosis rate with antiplatelet therapy without implementation of anticoagulant therapy. However, in three of these trials conflicting results were reported regarding the relative efficacy of various antiplatelet therapies. ⋯ In addition, the potential benefits of combination therapy with ticlopidine and aspirin apply only to patients at low risk as defined by the ACCP and ACC expert panels. Until further data become available, high-risk patients should be managed with conventional anticoagulation regimens. Studies are needed to determine whether antiplatelet therapy is effective in high-risk patients and the optimal antiplatelet therapy (ticlopidine, aspirin, or ticlopidine/aspirin) for the management of patients with coronary artery stents.
-
Comparative Study
The effect of ICU sedation guidelines and pharmacist interventions on clinical outcomes and drug cost.
To measure the effect of evidence-based intensive care unit (ICU) sedation guidelines and interventions by a pharmacist to promote these guidelines on the weaning time from mechanical ventilation and sedation drug cost. ⋯ High compliance with ICU sedation guidelines promoting lorazepam rather than midazolam or propofol in mechanically ventilated patients led to a 75% decrease in sedation drug costs and did not adversely affect the clinicians' ability to wean patients from mechanical ventilation.
-
To evaluate the efficacy and safety of intravenous potassium phosphate administered in a fixed-dose regimen in critically ill patients. ⋯ The administration of potassium phosphate 15 mmol to critically ill patients with mild-to-moderate hypophosphatemia over 3 hours is both effective and safe. The administration of potassium phosphate 30 mmol to severely hypophosphatemic patients was safe but achieved normalization of serum phosphate in a minority of patients. Either a higher dose or the subsequent administration of more potassium phosphate may be required to normalize serum phosphate concentrations. Once normalization has occurred, there is a high likelihood of redevelopment of hypophosphatemia over the following 2 days and supplementation should be given accordingly.