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 · Jan 2013
Comparative StudySodium citrate 4% versus heparin as a lock solution in hemodialysis patients with central venous catheters.
The effects of heparin versus sodium citrate 4% as a lock solution on catheter-related infections (CRIs), catheter patency, and hospitalizations in long-term hemodialysis patients with central venous catheters (CVCs) were compared. ⋯ In patients with long-term hemodialysis catheters, a lock solution of sodium citrate 4% was associated with fewer CRIs and similar effectiveness when compared with heparin 5000 units/mL.
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Am J Health Syst Pharm · Jan 2013
Accuracy of preparation of i.v. medication syringes for anesthesiology.
The results of a study of the accuracy of i.v. medication preparation by anesthesiologists are presented. ⋯ Analysis of different i.v. formulations of four medications prepared in syringes by anesthesiologists revealed a high rate of discrepancies between ordered and actual drug concentrations, suggesting a need for increased institutional efforts to prevent errors during the preparation process.
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An evaluation of a rules-based pharmacotherapy alerting system configured to identify improperly verified new medication orders in an inpatient setting is described. ⋯ Incorporation of a real-time pharmacotherapy alerting system with an oversight response process reduced the number of pharmacotherapy alerts and facilitated interception and prevention of adverse drug events.
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The etiology, pathophysiology, clinical presentation, and management of drug-induced hyperthermia (DIH) syndromes are reviewed. ⋯ DIH is a hypermetabolic state caused by medications and other agents that alter neurotransmitter levels. The treatment of DIH syndromes includes supportive care and pharmacotherapy as appropriate.
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Am J Health Syst Pharm · Jan 2013
GuidelineClinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the Intensive Care Unit: executive summary.
To revise the "Clinical Practice Guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult" published in Critical Care Medicine in 2002. ⋯ These guidelines provide a roadmap for developing integrated, evidence-based, and patient-centered protocols for preventing and treating pain, agitation, and delirium in critically ill patients.