American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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Off-label uses of the peripheral μ-opioid receptor antagonists alvimopan and methylnaltrexone are reviewed. ⋯ Trials of alvimopan in the FDA-approved use of methylnaltrexone (OIC) indicate potentially serious cardiovascular safety concerns and conflicting findings of efficacy. Similarly, trials of methylnaltrexone in the FDA-approved use of alvimopan (postoperative ileus) consistently showed no benefit. Evaluations of both drugs in their labeled conditions in populations not endorsed in their product labeling have been limited and largely unreplicated.
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The perioperative management of bariatric surgery patients is described. ⋯ The management of patients in the perioperative period of bariatric surgery requires appropriate selection and dosing of medications for pain management and treatment of infectious complications, VTE, bleeding, and other chronic diseases.
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Am J Health Syst Pharm · Jul 2014
Using failure mode and effects analysis to improve the safety of neonatal parenteral nutrition.
Failure mode and effects analysis (FMEA) was used to identify potential errors and to enable the implementation of measures to improve the safety of neonatal parenteral nutrition (PN). ⋯ FMEA was useful for detecting medication errors in the PN preparation process and enabling corrective measures to be taken. A checklist was developed to reduce errors in the most critical aspects of the process.