The Annals of pharmacotherapy
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Multicenter Study
Perceived versus actual sedation practices in adult intensive care unit patients receiving mechanical ventilation.
With drug shortages, newer sedative medications, and updates in research, management of sedation and delirium in patients receiving mechanical ventilation continues to evolve. ⋯ These data suggest differences in perceived and actual sedation practice in the US, as well as underutilization of evidence-based interventions. Most notable was the limited use of sedation treatment algorithms, daily interruption of sedation, and monitoring for delirium. Individual sedation and delirium protocols should be evaluated and updated based on evidence-based recommendations.
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Randomized Controlled Trial
Pharmacokinetics and monte carlo simulations of doripenem in patients with febrile neutropenia.
Doripenem is a group 2 carbapenem with enhanced in vitro activity against gram-negative bacteria including Pseudomonas aeruginosa. There is a paucity of pharmacokinetic/pharmacodynamic data on doripenem in patients with febrile neutropenia. ⋯ The findings from this analysis of doripenem suggest that higher doses, as well as prolonged infusions, may be necessary to optimally treat selected gram-negative bacteria (eg, P. aeruginosa) in patients with febrile neutropenia.
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To evaluate the teratogenic potential of statins in women of child-bearing age. ⋯ Human teratogenic risk has not been proven nor has it been ruled out by the available data on statin use in pregnancy. Possible differences in risk between individual statins require further evaluation. Additional data, including prospective observational cohorts with inadvertent maternal exposure to statins during early weeks of gestation, should further help to clarify appropriate recommendations for statin use in this population.
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Review
Intranasal fentanyl spray: a novel dosage form for the treatment of breakthrough cancer pain.
To review the pharmacology, pharmacokinetics, clinical efficacy, adverse events, dosing, and administration of intranasal fentanyl spray in the treatment of breakthrough cancer pain (BTCP) in adults. ⋯ For the treatment of BTCP, intranasal fentanyl spray offers improved onset of analgesia compared to other oral therapies; this improved onset of analgesia may closely mimic the typical time course of a BTCP episode. Nasal administration may overcome problems such as nausea, vomiting, or xerostomia that may complicate oral administration of analgesics. Potential disadvantages include uncertainty in treating more than 4 BTCP episodes per 24 hours and a higher cost compared to generically available oral opioid analgesics.
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To report a paradoxical reaction of Raynaud phenomenon following the repeated administration of iloprost in a patient with diffuse cutaneous systemic sclerosis with vascular involvement. ⋯ This case demonstrates a probable relationship between the rate of infusion of iloprost and the paradoxical reaction of Raynaud phenomenon.