The Annals of pharmacotherapy
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Synthetic cannabinoid-induced toxicity is increasing in frequency across the US, with more than 1057 reported cases as of August 2010. There is a paucity of literature on synthetic cannabinoid toxicity; however, there are various reports of adverse effects including tachycardia, hypertension, tachypnea, chest pain, heart palpitations, hallucinations, racing thoughts, and seizures. ⋯ This article reviews the development, abuse, toxicity, treatment, and legal status of synthetic cannabinoids. It is important for health-care professionals to recognize and appropriately treat synthetic cannabinoid-induced toxicity.
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To describe the use of argatroban as a procedural and bridging anticoagulant in a patient with a previous history of heparin allergy and atrial fibrillation undergoing carotid endarterectomy. ⋯ Argatroban may be an effective anticoagulant during carotid endarterectomy in patients with underlying chronic renal disease and a history of HIT. Additional research is needed to determine the ideal anticoagulant in vascular surgery when heparin cannot be utilized.
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Review Comparative Study
A Comparative Look at the Safety Profiles of Intravenous Iron Products Used in the Hemodialysis Population.
To review clinical trials conducted in hemodialysis patients of the 4 intravenous iron products available in the US in an attempt to discern strengths and inferiorities between products and evaluate current safety data that can be used to assist the clinician in selecting the most appropriate agent. ⋯ The newest intravenous iron product, ferumoxytol, has not been directly compared to the other 3 agents. Large well-controlled studies of these products specifically in the hemodialysis population would further help clinicians determine appropriate therapy. Iron sucrose appears to offer the most favorable safety profile when compared to iron dextran and sodium ferric gluconate in treating hemodialysis patients. Oxidative stress and hypersensitivity reactions are common problems encountered when administering intravenous iron.
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Previous trials investigating preoperative statin use for prevention of acute kidney injury following cardiovascular surgery were limited to patients undergoing a specific procedure and many used nonconsensus definitions of acute kidney injury. ⋯ Our findings do not support the hypothesis that preoperative statin use is associated with a decrease in the incidence of acute kidney injury following cardiac surgery utilizing cardiopulmonary bypass.
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To report a case of a critically elevated international normalized ratio (INR) following discontinuation of a vitamin K supplement in a patient receiving warfarin. ⋯ Discontinuation of vitamin K supplementation therapy might result in elevation of INR.