The Annals of pharmacotherapy
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To determine whether the potentiation of warfarin's anticoagulation effect, which occurred in two patients, was due to an interaction with fenofibrate. ⋯ Fenofibrate potentiates the effect of warfarin. Serial monitoring of the INR, at least three times per week, is therefore strongly recommended when initiating fenofibrate therapy in patients receiving warfarin.
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To present an 8-year (1985-1992) cumulative analysis of the 12,743 calls received by the Medication Information Line for the Elderly (MILE), a consumer-oriented drug information service. ⋯ Many older drug consumers have medication information needs that are not being met. Since a large proportion of the callers appeared to be self-motivated women, MILE may not be accessing all older consumers in need of information. This analysis also suggests that many older consumers are not aware that the pharmacist is available and capable of providing drug information.
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Case Reports
Respiratory depression following administration of intrathecal bupivacaine to an opioid-dependent patient.
To document two cases of respiratory depression in patients receiving morphine once the stimulating effect of pain on respiration was removed by bupivacaine. ⋯ Pain is a physiologic antagonist of the respiratory depressant effects of opioid analgesics. By reducing pain stimulation, bupivacaine may make patients more susceptible to opioid respiratory depression. Such situations require titration of bupivacaine and other analgesics as well as increased monitoring of the patient.
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To describe a case of pemoline-induced liver failure resulting in liver transplantation. ⋯ With increasing evidence linking pemoline to liver failure, this agent should not be considered first-line therapy for ADHD. Prior to initiating therapy, baseline liver function tests should be obtained and closely monitored, and parents and patients should be educated on the signs and symptoms of liver toxicity.
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To analyze patterns of prescription and nonprescription analgesic use in the general Swedish population, in association with predisposing factors, enabling factors, need, and health behavior. ⋯ This study shows that men and women differ in their choice between prescription and nonprescription analgesics and that the choice between prescription and nonprescription analgesics is influenced by an individual's pain, self-perceived health, and lifestyle.