Pharmacotherapy
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To determine if clopidogrel use before coronary artery bypass grafting (CABG) is associated with an increase in major bleeding, hemorrhage-related complications, or transfusion requirements. ⋯ Clopidogrel exposure within 7 days before CABG is associated with an increase in major bleeding, hemorrhage-related complications, and transfusion requirements, and leads to potentially greater consumption of health care resources. The overall risks and benefits for each patient should be considered before using the drug.
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Randomized Controlled Trial
Greater immediate gastric acid suppression with lansoprazole 30 mg administered as a 2-minute intravenous bolus injection versus a 30-minute infusion.
To compare the pharmacokinetics, pharmacodynamics, and safety of lansoprazole administered as a 2-minute intravenous bolus injection versus a 30-minute continuous infusion. ⋯ Greater immediate gastric acid suppression occurred after administration of lansoprazole 30 mg over 2 minutes than over 30 minutes, with other pharmacokinetic, pharmacodynamic, and safety profiles being similar.
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Review
Iron overload disorders: treatment options for patients refractory to or intolerant of phlebotomy.
Iron overload disorders involve excess accumulation of iron in body tissues as a result of hereditary and nonhereditary diseases. If left untreated, tissue iron deposition can result in organ damage. ⋯ Although phlebotomy is the gold standard for iron overload treatment in the setting of hereditary hemochromatosis, this procedure is usually not feasible for other iron overload conditions, especially those associated with anemia. With the introduction of newer, oral chelating agents, more options are available for patients refractory to or intolerant of parenteral chelating agents.
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To report our experience with rapid titration of levetiracetam regimens in children and adolescents who were unresponsive to or intolerant of other antiepileptic drugs. ⋯ Rapid dosage titration of levetiracetam is feasible and well tolerated in children who require rapid escalation to therapeutic doses.
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To assess the influence of withholding continuous enteral nutrition for 1 hour before and after warfarin administration compared with the coadministration of warfarin with continuous enteral nutrition on changes in international normalized ratios (INRs). ⋯ Continuous enteral nutrition should be withheld for 1 hour before and after warfarin administration to prevent enteral nutrition-associated warfarin resistance.