The Annals of pharmacotherapy
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To evaluate the evidence for valsartan in the treatment of heart failure and determine its need for formulary inclusion. ⋯ Valsartan is a safe and effective alternative for heart failure patients intolerant of ACE inhibitors. Valsartan has not been shown to be safe and effective when used in combination with ACE inhibitors.
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To systematically review the impact of interventions by community pharmacists on patients' adherence with chronic medication. ⋯ Currently, it is impossible to identify an overall successful adherence-improving strategy performed by pharmacists. More well-designed and well-conducted studies on the effectiveness of interventions by a community pharmacist to improve patient adherence to chronic medication need to be performed.
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Comparative Study Clinical Trial
Obesity does not alter the pharmacokinetics of drotrecogin alfa (activated) in severe sepsis.
Drotrecogin alfa (activated) [DrotAA] is approved for the reduction of mortality in adults with severe sepsis (sepsis with acute organ dysfunction) and high risk of death. Patients whose actual body weight was >135 kg were excluded from the Phase III PROWESS trial. ⋯ There is no statistically significant difference in Css concentrations or t1/2 of DrotAA between patients weighing < or =135 kg and >135 kg. DrotAA should be dosed by actual body weight.
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To report a case of methemoglobinemia secondary to the administration of topical benzocaine spray in an anemic patient who had previously undergone a lung transplant. ⋯ Application of the Naranjo probability scale established a highly probable relationship between topical benzocaine spray and methemoglobinemia and associated respiratory compromise. The risks of palliative use of topical benzocaine in patients with preexisting disorders that compromise oxygen delivery may outweigh any benefit. In our patient, anemia and lung disease increased his risk for clinically significant adverse respiratory events secondary to deficiencies or interferences in oxygen delivery. Topical benzocaine should be administered with caution and careful monitoring in such patient populations.
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To report a case of dystonia as an adverse effect of gabapentin. ⋯ Although gabapentin is widely used and well tolerated, it can cause dystonic reactions, which are reversible after drug withdrawal.