RESUMO
While these preliminary results in humans seem promising, no large trials have been conducted to compare vasopressin and epinephrine in CPR. At this time, standard guidelines using epinephrine are still preferred.
Assuntos
Reanimação Cardiopulmonar , Vasoconstritores/uso terapêutico , Vasopressinas/uso terapêutico , Epinefrina/uso terapêutico , Parada Cardíaca/terapia , HumanosRESUMO
Asparaginase is an effective treatment for patients with acute lymphocytic leukemia (ALL). Unfortunately, asparaginase therapy is associated with a high incidence of hypersensitivity reactions (up to 73%), including life-threatening anaphylaxis, and its half-life of approximately 20 hours necessitates daily administration. Pegaspargase, a modification of L-asparaginase, has a longer half-life (357 hours), a decreased incidence of hypersensitivity reactions, and when doses every 14 days, provides comparable efficacy to asparaginase; however, it is much more expensive per single-dose vial ($980.00 vs $52.38). To determine the pharmacoeconomic impact of the two agents, we conducted a cost-minimization analysis for three common adult ALL protocols. Results showed that pegaspargase was significantly less costly to payers on an inpatient or outpatient basis and warranted addition to our formulary.
Assuntos
Antineoplásicos/economia , Asparaginase/economia , Custos de Medicamentos/estatística & dados numéricos , Polietilenoglicóis/economia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/economia , Adulto , Assistência Ambulatorial/economia , Antineoplásicos/uso terapêutico , Asparaginase/administração & dosagem , Asparaginase/farmacocinética , Asparaginase/uso terapêutico , Protocolos Clínicos , Hipersensibilidade a Drogas , Meia-Vida , Hospitalização/economia , Humanos , Missouri , Polietilenoglicóis/administração & dosagem , Polietilenoglicóis/farmacocinética , Polietilenoglicóis/uso terapêuticoRESUMO
As changes are being made in the health care system, the roles and responsibilities of the pharmacist are evolving in direct patient care. The knowledge and skills necessary to succeed in these clinical positions are obtained through postgraduate training through pharmacy practice and specialty residencies and fellowships. Residency candidates are faced with important decisions in choosing which training programs to select and planning the course of the training. This article approaches the questions and decision-making process in residency selection from pharmacy residents' points of view.
Assuntos
Educação de Pós-Graduação em Farmácia/normas , Internato não Médico/normas , Serviço de Farmácia Hospitalar/organização & administração , Acreditação , Escolha da Profissão , Educação de Pós-Graduação em Farmácia/organização & administração , Hospitais de Ensino , Internato não Médico/organização & administração , Missouri , Técnicas de Planejamento , Avaliação de Programas e Projetos de SaúdeRESUMO
BACKGROUND: Sinus arrest is a rare complication of metoclopramide administration. CASE DESCRIPTION: A 51-year-old woman developed Guillain-Barre syndrome and severe dysautonomia. Metoclopramide was administered for the treatment of gastroparesis. Sinus arrest followed drug administration on several occasions and on rechallenge. CONCLUSIONS: After reviewing the literature and discussing possible etiologies for this unusual adverse drug reaction in this setting, we recommend that metoclopramide be used with caution in patients prone to develop bradyarrythmias, particularly those with dysautonomias and Guillain-Barre syndrome.
