The Annals of pharmacotherapy
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To report 4 patients who became excessively anticoagulated with the recommended or lower starting doses of argatroban during treatment for heparin-induced thrombocytopenia type II (HIT-II) in a cardiothoracic intensive care unit. ⋯ Formal pharmacokinetic studies of argatroban are needed in critically ill patients in order to optimize therapy.
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To report the effects of gabapentin in a patient with concurrent depression and posttraumatic stress disorder (PTSD) and review the use of antiepileptic drugs (AEDs) in PTSD. ⋯ AEDs may be of some therapeutic value in patients with PTSD. Future controlled studies are warranted to investigate the effectiveness of these agents.
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At the direction of the Food and Drug Administration, phenolphthalein was removed from all over-the-counter laxatives in 1999. Phenolphthalein was then replaced in most laxative products with the natural product senna from Cassia acutifolia Delile, which contains various anthraquinones. No data are available on the safety of senna use in children <6 years of age. ⋯ Unintentional ingestion of senna-containing laxatives in young children may potentially cause severe diaper rash, blisters, and skin sloughing.
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To evaluate the analgesic efficacy of calcitonin for treating the pain of vertebral fractures associated with osteoporosis. ⋯ Calcitonin has proven efficacy in acute pain associated with osteoporosis-related vertebral fractures. Analgesic effects are seen with intranasal, parenteral, and rectal administration. Future studies comparing calcitonin with other commonly used analgesics are needed to more clearly define its place in therapy.
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To determine the occurrence of and risk factors for opioid withdrawal in critically ill neonates receiving continuous infusions of fentanyl. ⋯ Opioid withdrawal occurs frequently in critically ill neonates who receive continuous infusions of fentanyl. Longer infusion duration and higher total dose were associated with withdrawal symptoms.