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 · Oct 2012
Case ReportsReversal of dabigatran-induced bleeding with a prothrombin complex concentrate and fresh frozen plasma.
The case of a patient for whom reversal of dabigatran-induced bleeding was performed with a prothrombin complex concentrate (PCC) and fresh frozen plasma (FFP) is reported. ⋯ Treatment with a PCC and FFP was administered to an 85-year-old man diagnosed with hemorrhagic shock secondary to bleeding in his upper gastrointestinal tract in an effort to reverse the anticoagulant effects of dabigatran. Although the patient's hemoglobin levels stabilized and his aPTT values decreased after treatment, he died as a result of multiorgan failure.
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Am J Health Syst Pharm · Oct 2012
Initiation of an emergency department pharmacy program during economically challenging times.
The initiation of a medication reconciliation program and other pharmacy services in the emergency department (ED) of a community hospital is described. ⋯ Implementation of an ED pharmacist program improved the admission medication reconciliation process and provided additional services to improve patient safety and quality of care.
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The most recent published evidence on the use of colloids versus crystalloids in critical care is reviewed, with a focus on population-dependent differences in safety and efficacy. ⋯ The results of the SAFE trial and a subgroup analysis of SAFE data suggest that colloids should be avoided in patients with trauma and traumatic brain injury. There are minimal differences in outcome between crystalloids and hypo-oncotic or iso-oncotic albumin for fluid resuscitation in severe sepsis; in select populations, such as patients undergoing cardiac surgery, the use of iso-oncotic albumin may confer a survival advantage and should be considered a first-line alternative.
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Am J Health Syst Pharm · Oct 2012
Effects of a direct refill program for automated dispensing cabinets on medication-refill errors.
The effects of a direct refill program for automated dispensing cabinets (ADCs) on medication-refill errors were studied. ⋯ A redesign of the ADC refill process using a wholesaler-to-ADC direct refill program that included delivery of prepackaged medication and bar-code-assisted refill significantly decreased the occurrence of ADC refill errors.