Annales pharmaceutiques françaises
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Since the advent of PDAs (Personal Digital Assistants), smartphones and Apps have been widely adopted by medical professionals. This craze has increased since 2007 and the first generation iPhone. In this context, 3 questions emerged for the pharmacist that we studied in this review: (1) What Apps are available for practice and how to find them? (2) What is useful for practice? (3) What precautions should be taken?
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Melanoma is a skin cancer that represents an actual public health problem. Its incidence is increasing every year. Environmental risk factors have been clearly identified. ⋯ This article is intended for community and hospital pharmacists and summarizes recommendations for primary and secondary prevention. It updates on new targeted therapies. It wants to give advices to the community pharmacists about the effective use of those treatments for melanoma.
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Each year, in France, the number of cardiac arrests is evaluated between 30,000 to 50,000. When a patient survives, he undergoes a post-resuscitation syndrome which can aggravate the injuries and for which nowadays, no medication is available. In some kinds of cardiac arrest, a hypothermia protocol can be applied with a need for monitoring because of the appearance of side effects. ⋯ The implied biochemical mechanisms are adenosine triphosphate potassium channels activation and cytochrome c oxidase inhibition. This molecule can also induce a suspended animation state characterized by a metabolism decrease, which could give a delay for physicians to start a therapeutic monitoring. Thus, in spite of a modest and sometimes contradictory literature, this compound could become the first neuroprotective molecule in cardiac arrest.
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Protamine is a polypeptide with low molecular weights that is used widely to reverse heparin anticoagulation during cardiac surgery. Protamine, efficient and relatively sure, can produce multiple adverse reactions after intravenous administration, including pulmonary hypertension, or systemic hypotension leading at times to cardiovascular collapse and death. Physiopathologic mechanisms, underlying these reactions, are not clear. ⋯ Preoperative identification of these factors should prompt specific preventive measures. The anesthesiologist and the cardiac surgeon must be vigilant when administrating protamine. Reheparinization and reinstitution of cardiopulmonary bypass should be considered in patients with refractory shock.
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Piperacillin/Tazobactam is a time-dependent antimicrobial combination (beta-lactam/beta-lactamase inhibitor) commonly used in the treatment of severe Gram-negative infections. The optimisation of its time-dependent bactericidal activity via continuous infusion could improve clinical outcomes. ⋯ In other articles, continuous infusion regimens are also more cost efficient. This article is an update, including the most recent trials about this subject.