The Annals of pharmacotherapy
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Nesiritide, a synthetic B-type natriuretic peptide, is used for the treatment of patients with acutely decompensated heart failure. Although nesiritide has been reported to worsen renal function, as reflected by significant elevations in serum creatinine (SCr), the impact of infusion duration on renal function has not been evaluated. ⋯ Nesiritide infusion of 24 hours or more appears to be significantly associated with elevated markers of worsening renal function in patients with acutely decompensated heart failure compared with infusion of less than 24 hours; however, prospective studies are needed to corroborate this finding.
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Randomized Controlled Trial Comparative Study
Perioperative nesiritide versus milrinone in high-risk coronary artery bypass graft patients.
Patients with left-ventricular dysfunction have an increased risk of developing heart failure after coronary artery bypass graft (CABG) surgery. Therapies to maintain cardiac output in such patients warrant investigation. Nesiritide is unique among intravenous medications used to manage heart failure. It mediates natriuresis and vasodilation and suppresses the reninangiotensin-aldosterone axis. Nesiritide may attenuate the body's neurohormonal response to myocardial stretch after CABG and provide clinical benefit in the immediate postoperative period. ⋯ Nesiritide does not decrease postoperative intensive care unit stay or other clinical parameters compared with milrinone in high-risk patients with hemodynamically stable left-ventricular function undergoing CABG surgery.
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Multicenter Study Clinical Trial
Solifenacin for overactive bladder with incontinence: symptom bother and health-related quality of life outcomes.
Approximately one-third of patients with overactive bladder (OAB) experience incontinence, a bothersome symptom with a clear negative effect on quality of life. ⋯ Patients reporting urge incontinence as their most bothersome OAB symptom can be expected to demonstrate significant improvements in multiple patient-related outcomes following treatment with flexibly dosed solifenacin.
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Opioid-related adverse drug events in surgical hospitalizations: impact on costs and length of stay.
Opioid analgesics remain a mainstay in the treatment of pain associated with surgical procedures. Such use is associated with adverse drug events (ADEs). ⋯ Opioid-related ADEs following surgery were associated with significantly increased LOS and hospitalization costs. These ADEs occurred more frequently in patients receiving higher doses of opioids.
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Randomized Controlled Trial
Electrocardiographic and hemodynamic effects of coenzyme Q10 in healthy individuals: a double-blind, randomized controlled trial.
Coenzyme Q10 (CoQ10) is an endogenous cofactor required for mitochondrial energy production and touted to treat heart failure and prevent statin-induced myopathy. In guinea pig ventricular myocytes, CoQ10 prolongs action potential duration, an effect that might prolong the QTc interval in humans. Additionally, CoQ10 reduced blood pressure in patients with essential hypertension. ⋯ One dose of CoQ10 does not have any effect on ECG variables and exhibits only mild and transient effect on systolic blood pressure in young, healthy people.