American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
-
Am J Health Syst Pharm · Sep 2009
ReviewManagement of loop diuretic resistance in the intensive care unit.
The management of loop diuretic resistance in the intensive care unit (ICU) is reviewed. ⋯ Loop diuretic resistance presents a challenge for clinicians in the ICU setting. Strategies to improve patients' responsiveness to these agents include fluid and salt restriction, switching from oral to i.v. loop diuretics, increasing diuretic dose, continuous infusion, and combination therapy with thiazides. Several of these strategies may be used concurrently to combat diuretic resistance and promote symptomatic relief of edema in the critically ill patient.
-
Am J Health Syst Pharm · Sep 2009
Effect of the ABCB1 3435C>T polymorphism on tacrolimus concentrations and dosage requirements in liver transplant recipients.
The effect of ABCB1 3435C>T on tacrolimus concentrations in liver transplant recipients was studied. Tacrolimus is a substrate for P-glycoprotein, the product of the ABCB1 gene. To determine whether the ABCB1 single-nucleotide polymorphism (SNP) 3435C>T was associated with variation in the tacrolimus concentration:dose ratio (C:D) in 42 liver transplant recipients during three months after transplantation. ⋯ The ABCB1 3435C>T polymorphism influenced the tacrolimus C:D in the first days after liver transplantation.
-
Am J Health Syst Pharm · Sep 2009
Effect of a pharmacist-run call center on medication access for ambulatory care patients.
An outreach program created to assist an outpatient hospital pharmacy with helping patients unable to afford the cost of prescriptions and to increase patient access to medications is described. ⋯ The collaboration between the MassMedLine outreach program and the outpatient pharmacy at a teaching hospital provided patients with long-term solutions for accessing and affording prescribed medications.
-
Am J Health Syst Pharm · Sep 2009
Coagulation factor VIIa (recombinant) in nonhemophilic patients requiring neurosurgery.
The clinical outcomes, safety, and use of resources associated with the administration of factor VIIa (recombinant) to nonhemophilic patients requiring neurosurgery were evaluated. ⋯ A protocol calling for administration of factor VIIa (recombinant) 40 microg/kg in nonhemophilic patients with coagulopathy and ICH led to a rapid and significant decrease in the INR, allowing for emergency surgical intervention. Few adverse events were detected in these patients, and none were deemed to be directly related to factor VIIa (recombinant).