The Annals of pharmacotherapy
-
To describe and discuss the use of continuous intravenous infusions of haloperidol to treat severe delirium and agitation in 3 intensive care unit (ICU) patients. ⋯ In selected patients, a continuous infusion of haloperidol may be a useful alternative for control of agitation and delirium. Close monitoring for QT prolongation or rhythm disturbances is mandatory.
-
Randomized Controlled Trial Clinical Trial
Effects of intravenous famotidine on gastric acid secretion in patients undergoing cardiac surgery.
To determine the effects of cardiopulmonary bypass and famotidine on gastric acid secretion in adults undergoing cardiac surgery. ⋯ Gastric acid secretion is decreased during and for 12 hours after cardiopulmonary bypass. Perioperative administration of famotidine suppresses gastric secretion in cardiac surgery patients.
-
Review Comparative Study
Beta-lactam antibiotics: is continuous infusion the preferred method of administration?
To examine the pharmacodynamic properties of the beta-lactam class of antibiotics and the rationale for their continuous infusion (CI), and to explore reasons that this mode of administration has not replaced intermittent infusion as the standard of practice. ⋯ Results of many animal and in vitro studies suggest that CI may be the optimal method of beta-lactam administration. Clinical trials need to further document the impact of the method of beta-lactam administration on the incidence of adverse effects, emergence of bacterial resistance, and patient outcome. Pharmacodynamic studies defining target beta-lactam concentrations, the practicality of CI in patients requiring multiple intravenous fluids and medications, and the pertinence of this issue when beta-lactam antibiotics are used as sole agents or in combination with other antimicrobials require further exploration.
-
To review the electrophysiologic properties and the in vitro, ex vivo, animal, and human data regarding proarrhythmic effects of intravenous vasopressors. ⋯ Controlled data supporting the proarrhythmic potential of intravenous vasopressors in humans are lacking. Sinus tachycardia, asymptomatic ventricular ectopic activity, and other ventricular or supraventricular arrhythmias have been reported in association with dopamine and epinephrine. Phenylephrine and methoxamine have been associated with sinus bradycardia, but otherwise may be antiarrhythmic. Intravenous vasopressors appear relatively safe w
-
Case Reports
Tissue necrosis and necrotizing fasciitis after intramuscular administration of diclofenac.
To report 6 cases of severe local reactions associated with intramuscular injection of diclofenac. ⋯ Intramuscular administration of diclofenac may be associated with severe tissue necrosis or necrotizing fasciitis. Although rare, these serious complications should be considered when intramuscular injection of NSAIDs is contemplated.