The Annals of pharmacotherapy
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To report a case of anaphylactoid reaction in an HIV-negative patient associated with the administration of intravenous ciprofloxacin. ⋯ The anaphylactoid reaction in our patient was probably induced by ciprofloxacin as validated by the Naranjo probability scale. Although anaphylactoid/anaphylactic reactions are rare adverse effects of ciprofloxacin and other fluoroquinolones, clinicians should be aware of this potentially fatal event.
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To report a case of dose-dependent angioedema secondary to the use of the angiotensin-receptor blocker (ARB) valsartan. ⋯ This is the third reported case of valsartan-induced angioedema and the first thought to be dose dependent. Practitioners should be aware of this potential adverse effect of valsartan, although the underlying cause is still not known.
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To compare the different sterility standards and the cost issues involved when choosing an opioid product for intraspinal administration. ⋯ The preservative-free commercially available products that are indicated for intrathecal/epidural use are the best alternative due to proper outside testing and stringent quality assurance. The generic morphine preservative-free product may also be considered if proper steps are taken to ensure that the final product is diluted properly.
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To report 2 cases of retroperitoneal hematoma in elderly patients receiving enoxaparin. ⋯ There are very few published reports implicating enoxaparin as a factor in retroperitoneal hematoma. It is hoped that the addition of these 2 cases to the medical literature creates more awareness that retroperitoneal hematoma should be considered in the differential diagnosis in patients receiving enoxaparin and experiencing unexplained decreases in hemoglobin and hematocrit.
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To review the pharmacology, pharmacokinetics, efficacy, and tolerability of extended-release (ER) metoprolol succinate and its role in the management of chronic heart failure. ⋯ ER metoprolol succinate therapy provides substantial mortality and morbidity benefits in patients with New York Heart Association class II and III heart failure who are stabilized on angiotensin-converting enzyme inhibitors and diuretics. ER metoprolol succinate is administered once daily, is well tolerated, and provides consistent beta(1)-blockade over the 24-hour dosing interval.