American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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Data collected from the Food and Drug Administration (FDA) under the Freedom of Information Act are presented to help clinicians understand the data prompting the black-box warning for droperidol and to make educated decisions regarding the use of droperidol and alternative agents. ⋯ Studies show that there is a dose-dependent increase in the rate of adverse cardiovascular events when droperidol is used either alone or in combination with other medications that cause Q-T interval prolongation. At this time, there does not appear to be significant evidence to suggest that serotonin type 3-receptor (5-HT(3)) antagonists are safer than droperidol with regard to Q-T interval prolongation. More studies are needed to determine the safety and efficacy of droperidol when used in doses of 0.625-1.25 mg compared with the 5-HT(3) antagonists.
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Am J Health Syst Pharm · May 2007
ReviewMedical marijuana and the developing role of the pharmacist.
The pharmacology, therapeutic uses, safety, drug-drug interactions, and drug-disease interactions of medical marijuana are reviewed, and the legal issues related to its use and the implications of medical marijuana for the pharmacist are presented. ⋯ Several states have legalized the use of marijuana for chronic and debilitating medication conditions. Pharmacists need to understand the complex legal framework surrounding this issue so that they can protect themselves and better serve their patients.
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Am J Health Syst Pharm · May 2007
Comparative StudyComparative costs of ertapenem and piperacillin-tazobactam in the treatment of diabetic foot infections.
To evaluate potential cost savings, trial data were used to determine the clinical outcomes for i.v. ertapenem given once daily and i.v. piperacillin-tazobactam given every six hours daily in treating diabetic foot infections. ⋯ A CMA of treatment of diabetic foot infections showed that, compared with piperacillin-tazobactam given four times daily i.v., ertapenem given once daily i.v. was associated with lower drug acquisition and supply costs and less time and labor devoted to preparation and administration of i.v. therapy.
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Am J Health Syst Pharm · May 2007
Association between common asthma therapies and recurrent asthma exacerbations in children enrolled in a state Medicaid plan.
To evaluate the effectiveness of budesonide inhalation suspension relative to other common asthma therapies in a high-risk population, a study was conducted to compare the risk of having a repeat asthma-related hospitalization or emergency department (ED) visit in a Medicaid population of children; the relationship between asthma medication adherence level and repeat asthma hospitalizations or ED visits was also evaluated. ⋯ Children with asthma and insured by Medicaid were at a high risk of repeat exacerbations leading to increased hospitalizations and ED visits. Treatment with budesonide inhalation suspension in the first 30 days after a hospitalization or ED visit for asthma was associated with a significant reduction in the risk of repeat asthma-related hospitalizations or ED visits during the following year. Children who were adherent to their asthma controller medication had significantly lower odds of having a subsequent asthma exacerbation.
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Recommendations for target blood glucose concentrations; factors that can complicate glycemic control; considerations that determine the aggressiveness of therapy to manage blood glucose levels; the role of oral antihyperglycemic drug therapy, sliding-scale insulin, continuous intravenous (i.v.) insulin infusions, and basal-bolus insulin therapy; the pharmacodynamics of various insulin products; computer decision support systems; and discharge planning for hospitalized patients with hyperglycemia are described. ⋯ Sliding-scale insulin is not effective. Continuous i.v. insulin therapy or intermittent s.c. basal-bolus plus correction injections is preferred. Proactive management of hyperglycemia using these methods is needed to achieve and maintain glycemic control in hospitalized patients.