American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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Am J Health Syst Pharm · Jun 2005
ReviewPrevention and treatment of postoperative nausea and vomiting.
The physiology, risk factors, and prevention and treatment of postoperative nausea and vomiting (PONV) are discussed. ⋯ Prophylactic antiemetic therapy for PONV is effective, but combinations of agents may be necessary for high-risk patients. Nonpharmacologic strategies are also important.
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Am J Health Syst Pharm · Jun 2005
Practice Guideline GuidelineBlueprint for implementing USP chapter 797 for compounding sterile preparations.
Guidelines for adopting and successfully implementing the requirements of the United States Pharmacopeia (USP) chapter 797 for compounding sterile preparations are presented. ⋯ Although the task of compliance with the requirements of USP chapter 797 may appear overwhelming, complicated, expensive, and even unattainable, quality can be established via a methodical and organized approach. After the systems have been implemented, maintaining them requires vigilance and follow-up. Compliance with chapter 797 involves up-front and ongoing costs associated with establishing these systems, but the time, energy, and cost required to maintain them are far less than those of retrospective or manual systems of collecting, reviewing, and collating quality assurance data on a monthly basis.
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The etiology, pathophysiology, prognostic factors, pharmacologic treatment, and pharmacoeconomic considerations of nonvariceal upper-gastrointestinal-tract bleeding (UGB) are reviewed. ⋯ Acid-suppressive therapy is beneficial in the management of UGB. It reduces the frequency of rebleeding, the need for surgery, transfusion requirements, and the length of hospital stay. To date, no pharmacologic intervention has demonstrated a reduction in the mortality rates of patients with UGB. An optimal acid-suppressive regimen has not yet been clearly established.
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Am J Health Syst Pharm · Jun 2005
ReviewPostoperative pain management with a patient-controlled transdermal delivery system for fentanyl.
The efficacy and safety of fentanyl hydrochloride patient-controlled trans-dermal system (PCTS) for management of acute postoperative pain are discussed. ⋯ Fentanyl hydrochloride PCTS is a self-contained iontophoretic fentanyl-delivery system that provides patients control over pain management and consistent management of pain without analgesic peaks and troughs.