American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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This article focuses on imatinib, how it has altered CML therapy, clinical trials that are the basis for its efficacy, and adverse effects associated with its current clinical use. ⋯ The development of therapeutic agents targeting BCR-ABL has revolutionized the treatment of chronic myeloid leukemia (CML). Imatinib has successfully allowed CML patients to remain in CP for at least five years in 90% of patients. Dasatinib has activity against a number of Imatinib-resistant mutants providing an additional therapeutic option for these patients.
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Infections caused by drug-resistant gram-negative bacteria are a growing threat to the healthcare community and clinicians are encouraged to employ a combination of strategies for effective prevention and treatment of these difficult infections. ⋯ With a limited number of antimicrobial agents in development, clinicians cannot rely on new drugs alone to treat infections due to drug-resistant gram-negative bacteria but must also incorporate strategies that reduce the emergence of resistance and prevent the spread of problematic bacteria. Potentially effective interventions include antimicrobial stewardship tactics that advocate optimal use of currently available antimicrobial agents and rigorous infection control measures. Infectious diseases trained pharmacists are in a unique position to play a key role in helping control the spread of nosocomial pathogens.
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The use, safety, and efficacy of intrathecal medication administration with implantable pumps for cancer and chronic pain management are reviewed. ⋯ The use of long-term intrathecal drug delivery for the treatment of intractable pain or intolerable medication adverse effects has expanded to include the treatment of patients with chronic or cancer-related pain. Important considerations for the use of intrathecal drug therapy include the appropriate selection of patients, delivery systems, and medications, as well as potential complications of therapy and quality-assurance measures necessary to ensure patient safety.
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The role of colistin in the treatment of infections caused by multidrug-resistant gram-negative microorganisms is discussed. ⋯ With vigilant monitoring of renal function and the avoidance of concomitant neurotoxic medications, colistin can be used safely and effectively with minimal adverse outcomes.