Irish medical journal
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Irish medical journal · Feb 2013
Safety of therapeutic hypothermia in post VF/VT cardiac arrest patients.
Therapeutic hypothermia (TH) is a process of cooling a patient post ventricular tachycardia/ventricular fibrillation (VT/VF) cardiac arrest to 32-34 degrees C for 24 hours. This improves neurological outcome and is part of current guidelines. Hypothermia prolongs QT interval, which can precipitate torsades de pointes (TdP). ⋯ QTc prolonged in all patients with an average of 80.3 + 57.2 ms., and up to 109.8 + 80.4 ms in patients who received Amiodarone concurrently. No TdP was seen in any patient. We conclude that TH is safe, though careful monitoring of the OTc interval is advisable especially with concurrent use of QT prolonging drugs.
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Irish medical journal · Feb 2013
Agomelatine: clinical experience and adherence to EMA recommendations for a novel antidepressant.
In 2009, the European Medicines Agency (EMA) granted marketing authorisation for the novel antidepressant agomelatine, with the recommendation that liver function tests (LFTs) are checked before, and 6, 12 and 24 weeks after, commencing the drug. This paper describes early clinical experience with agomelatine and audits physician adherence to EMA recommendations. A retrospective review of patients attending general adult psychiatry services in Carlow /Kilkenny (catchment population 120,000) over one year was performed. 62 patients were prescribed agomelatine. 32 patients (52%) had unipolar depression, and 43 (73%) were already established on antidepressant medication. 60 patients (97%) had LFTs measured before starting treatment with agomelatine, but half of patients (47%) did not have further LFTs as recommended. To increase adherence to EMA recommendations and ensure optimal patient safety, existing barriers to effective monitoring must be addressed.
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Patients are often unaware of the extensive duties of an anaesthetist and their significant contributions to patient management. This study aimed to evaluate current knowledge and perceptions of anaesthesia among an Irish patient population. 100 surgical patients completed multiple choice questionnaires which assessed patients knowledge of anaesthesia, the role of an anaesthetist and satisfaction with the consent process. 62 (62%) patients attributed their knowledge of anaesthesia to a previous operation and 78 (78%) patients knew that anaesthetists were qualified doctors. 30 (30%) patients were unaware that anaesthetists are involved in activities outside of the operation theatre. 44 (44%) patients wanted to be informed pre-operatively of all possible risks that can occur with anaesthesia and 82 (82%) would find an anaesthetics information leaflet helpful. 48 (48%) patients reported feeling anxious/fearful about undergoing anaesthesia. This data confirms existing research in other countries which indicates a need to further educate Irish patients about the roles of the anaesthetist and how anaesthesia is conducted.