The Annals of pharmacotherapy
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Opioids are utilized for pain management during and after mechanical ventilation in the intensive care unit (ICU). ⋯ Opioid prescribing for previously mechanically ventilated patients warrants improvement as a part of the discharge planning process. Application of these data may aid in the reduction of opioid overprescribing at discharge after an ICU stay.
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Four-factor prothrombin complex concentrate (4FPCC) is used for emergent warfarin reversal, but dosing remains controversial. Following approval, further studies have evaluated a variety of fixed-dose regimens. The studies utilized lower doses as compared with package insert dosing and provided data in regard to efficacy, safety, and cost savings. Further data are needed, however, to determine which fixed-dose regimen provides optimal efficacy and safety for emergent warfarin reversal. ⋯ A fixed-dose of 1500 units of 4FPCC successfully achieved a target INR of ≤1.5 in the majority of patients and resulted in no thrombotic events. This study adds to the data evaluating alternative 4FPCC dosing regimens in comparison to package insert recommended dosing.
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During a recent shortage of small-volume parenteral solutions, some hospitals administered piperacillin/tazobactam via continuous infusion to utilize larger fluid volumes. Although the incidence of acute kidney injury (AKI) is well documented for patients receiving intermittent or extended-infusion piperacillin/tazobactam with concomitant vancomycin, no literature exists documenting the incidence of AKI in patients receiving continuous-infusion piperacillin/tazobactam. ⋯ The incidence of AKI for VPT-CI found in this study was comparable to that found with intermittent and extended-infusion piperacillin/tazobactam with concomitant vancomycin in prior literature. Additional research should further analyze risk factors for the development of AKI for patients on concomitant vancomycin and piperacillin/tazobactam therapy.
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Review
Clinical Data for the Use of Cannabis-Based Treatments: A Comprehensive Review of the Literature.
To compile and synthesize the available literature describing medical cannabis use across various disease states. ⋯ As more states authorize medical cannabis use, there is an increasing need for high-quality clinical evidence describing its efficacy and safety. This review is intended to serve as a reference for clinicians, so that the risks and realistic benefits of medical cannabis are better understood.