Expert opinion on pharmacotherapy
-
Expert Opin Pharmacother · Mar 2003
ReviewCurrent pharmacotherapy for the treatment of severe burns.
The pharmacotherapy of burn care has evolved from the first topical antibiotics instituted > 30 years ago. These have helped greatly to reduce the incidence of burn wound sepsis, but a better understanding of the principles of burn care has resulted in earlier burn wound excision and complete coverage with autograft, cadaver skin, synthetic dressings, and amnion. This has markedly reduced septic complications and ameliorated the hypermetabolic response to burn injury. ⋯ Current therapy of frequently encountered problems, such as post-burn pruritus, prophylaxis of deep venous thrombosis and peptic ulceration, and pharmacological manipulation of inhalation injury in the burned patient is described. Current pharmacotherapy to ameliorate psychosocial problems associated with burns such as acute stress disorder, depression and post traumatic stress disorder are discussed. Better analgesics, newer antibiotics and immune stimulating drugs are required to reduce mortality and morbidity in large burns.
-
The burden of asthma is increasing in terms of prevalence, severity of symptoms and other markers of asthma control. Poor control of symptoms is a major issue that can result in adverse clinical and economic outcomes. Prescribing costs are the most obvious and visible expense in asthma care but these are but the tip of the iceberg. ⋯ Drug-related costs need to take into account savings made by decreased costs of other prescribed medication and patient factors must be taken into account. We need information that is applicable to the types of patients we see in the real world to make proper cost analyses. Such information can come from 'pragmatic' randomised trials, from retrospective claims analysis from observational studies or using primary care clinical and prescribing databases.