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 · Jun 2016
Evaluation of an updated insulin infusion protocol at a large academic medical center.
The performance of an updated insulin infusion protocol was evaluated at a large, academic medical center. ⋯ The median BG with an updated insulin infusion protocol approached the upper limit of the target BG range, and 41% of patients had a median BG above the goal range. Protocol specifications for the frequency of BG monitoring were not commonly followed, but the frequency of hypoglycemia was extremely low.
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Am J Health Syst Pharm · May 2016
ReviewReversal agents for use with direct and indirect anticoagulants.
The properties of three oral anticoagulant-specific reversal agents are reviewed, and guidance is presented to assist pharmacists in planning for the agents' introduction to the market. ⋯ As agents that provide rapid reversal of direct oral anticoagulant activity become available, advance planning will help hospitals to optimize their use.
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Am J Health Syst Pharm · May 2016
ReviewCurrent knowledge on assessing the effects of and managing bleeding and urgent procedures with direct oral anticoagulants.
Current knowledge on managing major bleeding events with available hemostatic agents, including their combined use with potential reversal agents, in patients taking direct oral anticoagulant (DOACs) is reviewed. ⋯ With or without reversal agents, patients may require supportive management such as mechanical pressure, volume support, transfusions of blood products, and, depending on the situation, surgery to repair the bleeding source. Specific reversal agents are currently under development or have recently been approved for the urgent management of bleeding events or the facilitation of invasive procedures in patients receiving DOACs.
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Am J Health Syst Pharm · May 2016
Cost-benefit evaluation of liposomal bupivacaine in the management of patients undergoing total knee arthroplasty.
Results of a cost-benefit analysis of intraoperative use of liposomal bupivacaine for postsurgical pain management in patients undergoing total knee arthroplasty (TKA) are presented. ⋯ In patients undergoing TKA, intraoperative administration of liposomal bupivacaine for management of postsurgical pain was found to offer advantages over usual care, including decreased time to ambulation and reduced hospital LOS.